Individual
KELLY KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 DIANE LN, SUFFIELD, CT 06078-2625
(860) 840-3137
Mailing address
80 DIANE LN, SUFFIELD, CT 06078-2625
(860) 840-3137
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001057
CT
2255A2300X
Athletic Trainer
2762
MA
Other
Enumeration date
02/04/2018
Last updated
02/04/2018
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