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General NPI Number Information
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NPI Number | 1932050697
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Entity Type | Organization
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Legal Business Name | KINESIO PHYSICAL THERAPY AND PERFORMANCE, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 135 E MAPLE AVE
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City | MONROVIA
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State | CA
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Zip | 91016-8405
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Country | US
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Telephone | 626-825-8514
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Fax |
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Provider Business Mailing Address
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Address Line | 738 W CHESTNUT AVE
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City | MONROVIA
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State | CA
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Zip | 91016-7230
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Country | US
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Telephone | 909-263-2094
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MATTHEW DANNEKER
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Credential | DPT
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Telephone | 909-263-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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