Provider Demographics
NPI:1699558056
Name:MCKENZIE, KENNY GITHERE (DPT)
Entity type:Individual
Prefix:
First Name:KENNY
Middle Name:GITHERE
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:KENNY
Other - Middle Name:GITHERE
Other - Last Name:MCKENZIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:7414 METCALF AVENUE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-648-6755
Mailing Address - Fax:913-648-6770
Practice Address - Street 1:7414 METCALF AVENUE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-648-6755
Practice Address - Fax:913-648-6770
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic