Provider Demographics
NPI:1720383300
Name:KERRVILLE PHYSICAL THERAPY HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:KERRVILLE PHYSICAL THERAPY HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:830-896-7377
Mailing Address - Street 1:711 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5904
Mailing Address - Country:US
Mailing Address - Phone:830-896-7377
Mailing Address - Fax:830-896-7393
Practice Address - Street 1:711 HILL COUNTRY DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5904
Practice Address - Country:US
Practice Address - Phone:830-896-7377
Practice Address - Fax:830-896-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health