Provider Demographics
NPI:1083848832
Name:KERN COUNTY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:KERN COUNTY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-322-7500
Mailing Address - Street 1:1201 24TH ST
Mailing Address - Street 2:B110-245
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2300
Mailing Address - Country:US
Mailing Address - Phone:661-326-1900
Mailing Address - Fax:661-326-0391
Practice Address - Street 1:3201 F ST STE 250
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1846
Practice Address - Country:US
Practice Address - Phone:661-326-1900
Practice Address - Fax:661-326-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT8859261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy