MEDICARE: JULIANNE PRATT KENWARD P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	011648-1	NY

General Provider Information

NPI Number	:	1053636746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE PRATT KENWARD P.T.

Provider Business Mailing Address
First Line	:	2005 SHERIDAN DR
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14223-1222
Country	:	US
Telephone Number	:	716-541-9200
Fax Number	:	716-299-2011

Provider Business Practice Location Address
First Line	:	989 BLOSSOM RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14610-2251
Country	:	US
Telephone Number	:	585-482-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	04/06/2010

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