# INTELKINETIC THERAPEUTIC CONNECTIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215600895
- **Authorized official:** JASONRIC VILLANUEVA DPT (OWNER/DPT)
- **Authorized official phone:** (704) 680-2834

## Contact information

- **Practice address:** 2210 PENFIELD LN, BOWIE, MD 20716-1426
- **Practice address phone:** (704) 680-2834
- **Mailing address:** 3540 CRAIN HWY UNIT 397, BOWIE, MD 20716-1303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2021
- **Last updated:** 07/29/2021