Provider Demographics
NPI:1598637076
Name:KINETIC CARE THERAPY LLC
Entity type:Organization
Organization Name:KINETIC CARE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEYINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLAWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:909-751-8039
Mailing Address - Street 1:12328 MELODY TURN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2943
Mailing Address - Country:US
Mailing Address - Phone:909-751-8039
Mailing Address - Fax:
Practice Address - Street 1:12328 MELODY TURN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-2943
Practice Address - Country:US
Practice Address - Phone:909-751-8039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty