Individual
KENNETH DAVID RESCOTT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
37 W GARDEN ST, SUITE 103, AUBURN, NY 13021-2662
(315) 252-8112
Mailing address
37 W GARDEN ST, SUITE 103, AUBURN, NY 13021-2662
(315) 252-8112
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
010567
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02226626
—
NY
Enumeration date
08/16/2005
Last updated
07/08/2007
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