Kenny Gaston
Kenny Gaston is a Physical Therapist in Private Practice in Mitchellville, Maryland. Qualified in 2019, 7 years ago. Practices with Sports Pro Physical Therapy East, a 2-clinician group and accepts Medicare assignment.
- Years since qualifying
- 7
- In the registry since
- 2018
Practice location Address checks out
Mitchellville, MDNo coordinates on file. Search this address in Google Maps
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1205302973 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | October 19, 2018 |
| Last updated in NPPES | October 19, 2018 |
Medicare enrollment
| Medicare specialty | PHYSICAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2019 (7 years in practice) |
| Group practice | Sports Pro Physical Therapy East — 2 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
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