Organization
LIVE YOUNG PLLC
Active
Other names
Live Young Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY M KENNEDY DC (OWNER)
(772) 212-1111
Entity
Organization
Contact information
Practice address
1680 SW SAINT LUCIE WEST BLVD STE 204, PORT ST LUCIE, FL 34986-1927
(772) 212-1111
(772) 212-0201
Mailing address
318 SE FISK RD, PORT ST LUCIE, FL 34984-8920
(860) 883-5850
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
CH11346
FL
Other
Enumeration date
06/09/2016
Last updated
02/12/2019
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