Individual
MR. KENNETH DAVID PASTERNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
14260 S DENNY BLVD, LITCHFIELD PARK, AZ 85340-9448
(623) 536-7400
Mailing address
822 ROCK LAKE GLN, FORT MILL, SC 29715-6442
(704) 517-4273
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2083653
TX
225200000X
Physical Therapy Assistant
4607
NC
225200000X
Physical Therapy Assistant
Primary
9618A
AZ
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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