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Individual
DR. KELLY DAVID KENNEDY
Active
Individual
DR. KELLY DAVID KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00256200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073687000
AMERIHEALTH
NJ
01
—
1084117
HORIZON MERCEY
NJ
05
—
192260201
—
NJ
01
—
23278
AMERICAID
NJ
01
—
702524
UNITED HEALTHCARE
NJ
01
—
CA000004801
AMERICHOICE
NJ
01
—
P441526
OXFORD
NJ
Enumeration date
08/05/2006
Last updated
09/21/2011
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