Provider Demographics
NPI:1093097081
Name:KENDALL, EYDIE (PT, PHD)
Entity Type:Individual
Prefix:DR
First Name:EYDIE
Middle Name:
Last Name:KENDALL
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HIGH STREET
Mailing Address - Street 2:MSC 68
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1595
Mailing Address - Country:US
Mailing Address - Phone:208-659-5848
Mailing Address - Fax:
Practice Address - Street 1:51 BROOK RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:NH
Practice Address - Zip Code:03222-5302
Practice Address - Country:US
Practice Address - Phone:208-659-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-5852251P0200X
NH43052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics