Provider Demographics
NPI:1376791558
Name:HAMILTON, KATHLEEN KENNY (PT)
Entity Type:Individual
Prefix:MR
First Name:KATHLEEN
Middle Name:KENNY
Last Name:HAMILTON
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 1:1055 ABERDEEN CT N
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3300
Mailing Address - Country:US
Mailing Address - Phone:251-533-3969
Mailing Address - Fax:
Practice Address - Street 1:1758 SPRINGHILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3508
Practice Address - Country:US
Practice Address - Phone:251-479-0551
Practice Address - Fax:251-479-0522
Is Sole Proprietor?:No
Enumeration Date:2008-08-31
Last Update Date:2008-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2462251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL246OtherPHYSICAL THERAPIST