Provider Demographics
NPI:1841612967
Name:KENNEBEC PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:KENNEBEC PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:14 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:ME
Mailing Address - Zip Code:04344-2931
Mailing Address - Country:US
Mailing Address - Phone:207-582-9898
Mailing Address - Fax:207-582-9899
Practice Address - Street 1:14 SECOND ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:ME
Practice Address - Zip Code:04344-2931
Practice Address - Country:US
Practice Address - Phone:207-582-9898
Practice Address - Fax:207-582-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty