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Individual

KENNEDY BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7500 UNIVERSITY DR, BISMARCK, ND 58504-9652
(701) 355-8030
Mailing address
9005 OAK DR, BISMARCK, ND 58503-6539
(701) 955-5815

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
ND
390200000X
Student in an Organized Health Care Education/Training Program
Primary
ND

Other

Enumeration date
01/17/2026
Last updated
01/17/2026
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