Provider Demographics
NPI:1528707726
Name:KINETIC FLOW PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:KINETIC FLOW PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-320-4023
Mailing Address - Street 1:11913 AVON WAY
Mailing Address - Street 2:STE 4
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066
Mailing Address - Country:US
Mailing Address - Phone:270-320-4023
Mailing Address - Fax:
Practice Address - Street 1:11913 AVON WAY
Practice Address - Street 2:STE 4
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-9006
Practice Address - Country:US
Practice Address - Phone:270-320-4023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty