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Individual

MRS. KENZIE KAY CORNIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS, PTA

Contact information

Practice address
1514 N ZARAGOZA RD STE B4, EL PASO, TX 79936-8041
(915) 257-5782
Mailing address
1531 GEORGE DIETER DR APT 1022, EL PASO, TX 79936-7673
(574) 601-7659

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
21419
TX
225200000X
Physical Therapy Assistant
Primary
2141976
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2141926
TX
Enumeration date
08/19/2018
Last updated
08/19/2018
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