Kennel, Victor D

Kennel, Victor D is an individual health care provider with primary practice located at 707 Hollybrook Dr Suite 500, Longview TX 75605-2410. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Kennel, Victor D can be contacted via phone (903) 291-6113.

Contact Information

Primary practice address
707 Hollybrook Dr Suite 500 Longview TX 75605-2410
Phone: (903) 291-6113
Fax: (903) 234-9126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1060564 Texas

Profile Details

NPI number 1730170309
LBN Legal business name Kennel, Victor D
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Sep 24th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730170309 NPPES
Texas MEDICAID 171660706

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