Provider Demographics
NPI:1679017842
Name:KINNEY PHYSICAL THERAPY & WELLNESS,P.C.
Entity Type:Organization
Organization Name:KINNEY PHYSICAL THERAPY & WELLNESS,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-444-9546
Mailing Address - Street 1:605 HAMPSHIRE RD
Mailing Address - Street 2:#434
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2382
Mailing Address - Country:US
Mailing Address - Phone:805-444-9546
Mailing Address - Fax:
Practice Address - Street 1:2955 E HILLCREST DR
Practice Address - Street 2:#108
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3176
Practice Address - Country:US
Practice Address - Phone:805-494-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty