Provider Demographics
NPI:1649519224
Name:LOUIS KENDRICK
Entity type:Organization
Organization Name:LOUIS KENDRICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:WILLAIM
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:313-613-0529
Mailing Address - Street 1:655 WELLINGTON CRES
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2948
Mailing Address - Country:US
Mailing Address - Phone:586-468-6171
Mailing Address - Fax:
Practice Address - Street 1:655 WELLINGTON CRES
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2948
Practice Address - Country:US
Practice Address - Phone:586-468-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-03
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001795251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health