Provider Demographics
NPI:1184710873
Name:KENNELL, ROB E (MPT)
Entity type:Individual
Prefix:MR
First Name:ROB
Middle Name:E
Last Name:KENNELL
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Gender:M
Credentials:MPT
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Mailing Address - Street 1:2620 S WILLIAMS PL
Mailing Address - Street 2:STE 110
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1867
Mailing Address - Country:US
Mailing Address - Phone:509-737-0333
Mailing Address - Fax:509-737-0355
Practice Address - Street 1:2620 S WILLIAMS PL
Practice Address - Street 2:STE 110
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1867
Practice Address - Country:US
Practice Address - Phone:509-737-0333
Practice Address - Fax:509-737-0355
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPT00007246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8809033Medicare PIN