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Individual
MR. CHARLES REGGIE KENNEDY SR.
Active
Individual
MR. CHARLES REGGIE KENNEDY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CERTIFIED ORTHOTIST
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
C0004097
MS
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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