Provider Demographics
NPI:1194415778
Name:GENSLINGER, MCKENZI (DPT)
Entity type:Individual
Prefix:DR
First Name:MCKENZI
Middle Name:
Last Name:GENSLINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MCKENZI
Other - Middle Name:
Other - Last Name:HERBST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:19259 ELSTON WAY
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6486
Mailing Address - Country:US
Mailing Address - Phone:630-947-5150
Mailing Address - Fax:
Practice Address - Street 1:19259 ELSTON WAY
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-6486
Practice Address - Country:US
Practice Address - Phone:630-947-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist