Individual
DR. KYLE T FENNEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
100 BECKS WOODS DR, SUITE 101, BEAR, DE 19701-3835
(302) 392-3400
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002306
DE
225100000X
Physical Therapist
JT0000684
DE
Other
Enumeration date
01/08/2008
Last updated
06/13/2012
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