Provider Demographics
NPI:1356931398
Name:ZAREMBA, KENNY II
Entity type:Individual
Prefix:
First Name:KENNY
Middle Name:
Last Name:ZAREMBA
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MICHAEL CIR NE
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-7617
Mailing Address - Country:US
Mailing Address - Phone:256-997-3440
Mailing Address - Fax:
Practice Address - Street 1:201 45TH ST NE
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-4011
Practice Address - Country:US
Practice Address - Phone:256-845-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer