Brent Sheldon Kennedy, DPT | |
3715 Woodking Dr, Idaho Falls, ID 83404-4720 | |
(208) 529-2255 | |
(208) 529-2022 |
Full Name | Brent Sheldon Kennedy |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 22 Years |
Location | 3715 Woodking Dr, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295855112 | NPI | - | NPPES |
806757200 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | RPT-1740 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Foothills Rehabilitation And Performance Services Pllc | 6406077999 | 7 |
Provider Name | Foothills Rehabilitation & Performance Services Pllc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1063829836 PECOS PAC ID: 6406077999 Enrollment ID: O20141027001351 |
Mailing Address | Practice Location Address |
---|---|
Brent Sheldon Kennedy, DPT 2335 Ptarmigan Way, Ammon, ID 83401-5850 Ph: (208) 552-5661 | Brent Sheldon Kennedy, DPT 3715 Woodking Dr, Idaho Falls, ID 83404-4720 Ph: (208) 529-2255 |
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