MEDICARE: KYLE A KENDALL PT

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	9156	TN
2	225100000X	Physical Therapist	5893	KY

General Provider Information

NPI Number	:	1255615464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE A KENDALL PT

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR STE 300
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7285
Country	:	US
Telephone Number	:	615-373-1350
Fax Number	:	615-221-9054

Provider Business Practice Location Address
First Line	:	2011 GRINSTEAD DR
Second Line	:	SUITE 102
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1295
Country	:	US
Telephone Number	:	502-813-7838
Fax Number	:	502-813-7839

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

Provider Enumeration Date	:	10/06/2011
Last Update Date	:	10/04/2019

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Directions to “ KYLE A KENDALL PT” Practice Location

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