National Provider Identifier
Ian Michael Kennedy, DPT
Ian Michael Kennedy, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Medina, NY and a listed phone number of (585) 798-2000.
Profile Overview
- NPI
- 1043088750
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- December 13, 2023
- Last Updated
- December 13, 2023
Practice Location
- 200 Ohio St
- Medina, NY 14103-1063
Phone: (585) 798-2000
Mailing Address
- 6141 Versailles RD
- Lake View, NY 14085-9625
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1043088750
- Entity Type
- Individual
- Last Name
- Kennedy
- First Name
- Ian
- Middle Name
- Michael
- Credential
- DPT
- Mailing Street Address
- 6141 Versailles RD
- Mailing City
- Lake View
- Mailing State
- NY
- Mailing ZIP Code
- 14085-9625
- Mailing Country
- US
- Mailing Phone
- (716) 400-4725
- Practice Street Address
- 200 Ohio St
- Practice City
- Medina
- Practice State
- NY
- Practice ZIP Code
- 14103-1063
- Practice Country
- US
- Practice Phone
- (585) 798-2000
- Enumeration Date
- December 13, 2023
- Last Updated
- December 13, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 13, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)