Provider Demographics
NPI:1861823908
Name:KINEMATIC CONCEPTS PHYSICAL THERAPY & SPORTS REHAB, PLLC
Entity Type:Organization
Organization Name:KINEMATIC CONCEPTS PHYSICAL THERAPY & SPORTS REHAB, PLLC
Other - Org Name:MOMENTUM PHYSICAL THERAPY & SPORTS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MALFER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-695-8731
Mailing Address - Street 1:8627 CINNAMON CREEK DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1480
Mailing Address - Country:US
Mailing Address - Phone:210-695-8731
Mailing Address - Fax:210-598-0432
Practice Address - Street 1:7003 S NEW BRAUNFELS AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-4588
Practice Address - Country:US
Practice Address - Phone:210-892-0359
Practice Address - Fax:210-253-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX647890008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty