Provider Demographics
NPI:1205171360
Name:SHRINER, KENDRA L (PTA)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:L
Last Name:SHRINER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 PEN RD NW
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43748-9714
Mailing Address - Country:US
Mailing Address - Phone:740-605-4527
Mailing Address - Fax:
Practice Address - Street 1:5105 PEN RD NW
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OH
Practice Address - Zip Code:43748-9714
Practice Address - Country:US
Practice Address - Phone:740-605-4527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7326225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant