Provider Demographics
NPI:1962398875
Name:KENNEDY, DANIEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KENNEDY
Suffix:
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 1:8014 MORRELL LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6669
Mailing Address - Country:US
Mailing Address - Phone:919-475-7062
Mailing Address - Fax:
Practice Address - Street 1:8014 MORRELL LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6669
Practice Address - Country:US
Practice Address - Phone:919-475-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist