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Organization

MATTHEW P DANNEKER

Active
Other names
Kinesio Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW P DANNEKER (OWNER/DIRECTOR)
(760) 503-5455
Entity
Organization

Contact information

Practice address
16049 TUSCOLA RD STE A, APPLE VALLEY, CA 92307-0824
(909) 263-2094
Mailing address
738 W CHESTNUT AVE, MONROVIA, CA 91016-7230
(760) 503-5455

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
261QP2000X
Physical Therapy Clinic/Center
33987
CA

Other

Enumeration date
12/29/2017
Last updated
08/07/2018
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