Provider Demographics
NPI:1124539135
Name:MCWHORTER, DENNIS KEVIN (LPTA)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:KEVIN
Last Name:MCWHORTER
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6632 RITA DR
Mailing Address - Street 2:
Mailing Address - City:ENON
Mailing Address - State:OH
Mailing Address - Zip Code:45323-1237
Mailing Address - Country:US
Mailing Address - Phone:937-371-5389
Mailing Address - Fax:
Practice Address - Street 1:6632 RITA DR
Practice Address - Street 2:
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1237
Practice Address - Country:US
Practice Address - Phone:937-371-5389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6007225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant