Provider Demographics
NPI:1801008826
Name:KINETIX REHAB SERVICES, PLLC
Entity Type:Organization
Organization Name:KINETIX REHAB SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:SULIT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:512-417-6456
Mailing Address - Street 1:1000 E VERMONT AVE APT 4111
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1704
Mailing Address - Country:US
Mailing Address - Phone:512-417-6456
Mailing Address - Fax:
Practice Address - Street 1:1000 E VERMONT AVE APT 4111
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1704
Practice Address - Country:US
Practice Address - Phone:512-417-6456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170169225100000X
TX2061050225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty