Provider Demographics
NPI:1992067037
Name:KEE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:KEE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:GENNRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-401-3566
Mailing Address - Street 1:6620 WEISS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2756
Mailing Address - Country:US
Mailing Address - Phone:989-401-3566
Mailing Address - Fax:989-401-3745
Practice Address - Street 1:6620 WEISS ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2756
Practice Address - Country:US
Practice Address - Phone:989-401-3566
Practice Address - Fax:989-401-3745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010037442251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty