Provider Demographics
NPI:1639371545
Name:KENT PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:KENT PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:318-201-9282
Mailing Address - Street 1:8424 RIDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-2626
Mailing Address - Country:US
Mailing Address - Phone:318-201-9282
Mailing Address - Fax:
Practice Address - Street 1:2735 CULPEPPER RD
Practice Address - Street 2:SUITE B AND C
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-2502
Practice Address - Country:US
Practice Address - Phone:318-201-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04299R261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy