Provider Demographics
NPI:1619367208
Name:BEYL, KENDALL (DPT)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:BEYL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:
Other - Last Name:VOELKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:706-236-2774
Mailing Address - Fax:706-236-2783
Practice Address - Street 1:100 LINDSEY LN # A
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6850
Practice Address - Country:US
Practice Address - Phone:912-729-1333
Practice Address - Fax:912-729-5259
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34265225100000X
GAPT011811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist