Provider Demographics
NPI:1689153587
Name:KENDRICK, SHANNON LYNN (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:LYNN
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:LYNN
Other - Last Name:KARPOVITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:200 MOUNT OLIVE RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37705-2712
Mailing Address - Country:US
Mailing Address - Phone:401-862-8826
Mailing Address - Fax:
Practice Address - Street 1:11201 W POINT DR STE 104
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2834
Practice Address - Country:US
Practice Address - Phone:865-392-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist