Ike Manning Kent, P.T.

Individual provider Active NPI Physical Therapist · Thomasville, GA

NPI 1144359043 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1144359043
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT004826 (GA)
Practice address
212 West Hansell Street
Thomasville, GA 31792
Phone
(229) 228-8050
Fax
(229) 228-8594
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT004826GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks County Hospital Past Accepting new patients
Brooks County Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT004826 GA Yes

Addresses

Primary practice location

212 West Hansell Street
Thomasville, GA 31792

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Other identifiers

IdentifierTypeStateIssuer
PT004826OtherGALICENSE

Other providers in Thomasville, GA

All providers in Thomasville, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.