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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACK KIDWELL

Active Sole Proprietor

JACK KIDWELL is a Physical Therapy Assistant healthcare provider located in MIDDLEBURG HEIGHTS, Ohio. NPI 1659504868 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · MIDDLEBURG HEIGHTS, OH

Registration Details

NPI Number
1659504868
Provider Type
Individual
Gender
Male
NPI Issued
Sep 3, 2009 (16.910889094524 yrs)
Last Updated
Apr 14, 2016
Licenses
PT9064 (OH)
PT9064 (OH)
Sole Proprietor
Yes

Practice Information

Address
18697 BAGLEY RD
MIDDLEBURG HEIGHTS, OH, 441303417
Browse OH providers · Browse ZIP 44130
Phone
2169260699
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Clinic

Other Physical Therapy Assistant Providers in MIDDLEBURG HEIGHTS, OH

Name Credential NPI
LORI A. LABAS P.T. 1972581379
MR. DAVID MICHAEL GRAYGO MPT 1215993621
RUSSELL SCOTT MAGERS PT 1336190800
MRS. CARRIE LYNN HOFFMAN P.T. 1518052265
DR. LYNSEY BARON PT, DPT, CLT 1346660362
LISA GALLAGHER PT, DPT 1477967651
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.