Provider Demographics
NPI:1053636746
Name:KENWARD, JULIANNE PRATT (PT)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:PRATT
Last Name:KENWARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1222
Mailing Address - Country:US
Mailing Address - Phone:716-541-9200
Mailing Address - Fax:716-299-2011
Practice Address - Street 1:989 BLOSSOM RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-2251
Practice Address - Country:US
Practice Address - Phone:585-482-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011648-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist