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Individual
KENNETH IRVING MCDONALD
Active
Individual
KENNETH IRVING MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 14744
CA
225100000X
Physical Therapist
Primary
PT34821
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ08904Z
BLUE SHIELD
CA
Enumeration date
10/18/2007
Last updated
09/18/2019
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