Provider Demographics
NPI:1659640605
Name:KNH LLC
Entity Type:Organization
Organization Name:KNH LLC
Other - Org Name:ELITE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:501-733-0104
Mailing Address - Street 1:PO BOX 11226
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0022
Mailing Address - Country:US
Mailing Address - Phone:501-733-0104
Mailing Address - Fax:
Practice Address - Street 1:235 CASTLEBERRY DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7798
Practice Address - Country:US
Practice Address - Phone:501-733-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty