Individual
KENNAN MCVEY WYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
500 IRVINGTON ROAD, KILMARNOCK, VA 22482-0128
(804) 435-3435
(804) 435-3682
Mailing address
500 IRVINGTON ROAD, PO BOX 128, KILMARNOCK, VA 22482-0128
(804) 435-3435
(804) 435-3682
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305210037
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305210037
PT LICENSE
VA
Enumeration date
03/31/2016
Last updated
08/14/2019
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