Provider Demographics
NPI:1083212252
Name:KENNY, DOROTHY ANN
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANN
Last Name:KENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-356-4705
Mailing Address - Fax:717-207-8919
Practice Address - Street 1:1600 6TH AVE STE 108
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2626
Practice Address - Country:US
Practice Address - Phone:717-356-4705
Practice Address - Fax:717-207-8919
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
PAPT025203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist