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Organization
KENNEDY CHIROPRACTIC CLINIC, INC
Active
Organization
KENNEDY CHIROPRACTIC CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLY KENNEDY D.C. (OWNER/ CHIROPRACTIC PHYSICIAN)
(941) 929-0020
Entity
Organization
Contact information
Practice address
4155 CLARK RD, SARASOTA, FL 34233-2403
(941) 929-0020
(941) 921-7843
Mailing address
4155 CLARK RD, SARASOTA, FL 34233-2403
(941) 929-0020
(941) 921-7843
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0006233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22563
MEDICARE PTAN / BCBS PROVIDER #
FL
Enumeration date
08/25/2010
Last updated
08/08/2014
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