Provider Demographics
NPI:1053791020
Name:KENDALL, BETH ANN (DPT)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:KENDALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3059 WAVERLY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26187-7933
Mailing Address - Country:US
Mailing Address - Phone:740-350-1116
Mailing Address - Fax:
Practice Address - Street 1:3059 WAVERLY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187-7933
Practice Address - Country:US
Practice Address - Phone:740-350-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH 011752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist