Individual
KIMBERLY SHANTALE KENNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
802 DAVIS ST, JACKSONVILLE, NC 28540-4927
(910) 581-7745
Mailing address
802 DAVIS ST, JACKSONVILLE, NC 28540-4927
(910) 581-7745
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11806
NC
225700000X
Massage Therapist
—
—
Other
Enumeration date
04/30/2024
Last updated
04/30/2024
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