Most Relevant Information
Provider Data
| NPI Number: | 1003418765 |
| Provider Name: | KENNEDY POPLAWSKI GILLESPIE DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 299461 |
Most Important Dates
| Enumeration Date: | 11/09/2020 |
| Last Updated: | 11/29/2022 |
Provider Practice Location
90 E USTICK RD STE 150
MERIDIAN
ID
836466134
Practice Location Phone/Fax
| Phone: | 2088950715 |
| Fax: | 2088950746 |
Provider Mailing Location
90 E USTICK RD STE 150
MERIDIAN
ID
836466134
Provider Mailing Phone/Fax
| Phone: | 2088950715 |
| Fax: | 2088950746 |