Provider Demographics
NPI:1871276808
Name:NEWMAN, KENNETH JR (PT, DPT)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:NEWMAN
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8107 W 129TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-3714
Mailing Address - Country:US
Mailing Address - Phone:913-972-3822
Mailing Address - Fax:
Practice Address - Street 1:141 S PARKER ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-4043
Practice Address - Country:US
Practice Address - Phone:913-732-0836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist