Individual
MR. EVAN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
101 13TH ST, HUNTINGTON, WV 25701-1653
(304) 525-7622
Mailing address
101 13TH ST, HUNTINGTON, WV 25701-1653
(304) 525-7622
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1965
WV
Other
Enumeration date
08/16/2014
Last updated
08/16/2014
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