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NPI Code Detail

MEDICARE: CLINT KENNEDY PT, DPT

MEDICARE: CLINT KENNEDY PT, DPT
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
1225100000XPhysical Therapist1407310TX

General Provider Information

NPI Number : 1396623625
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLINT KENNEDY PT, DPT
Provider Business Mailing Address
First Line : 221 N MAIN AVE
Second Line :
City : LAMESA
State : TX
Zip : 79331-5533
Country : US
Telephone Number : 806-200-5030
Fax Number : 806-370-6484
Provider Business Practice Location Address
First Line : 221 N MAIN AVE
Second Line :
City : LAMESA
State : TX
Zip : 79331-5533
Country : US
Telephone Number : 806-200-5030
Fax Number : 806-370-6484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2025
Last Update Date : 04/07/2026

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Directions to “ CLINT KENNEDY PT, DPT” Practice Location

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