Organization
FAMILY FIRST HEALTH CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD ANTHONY KENNEDY D.C. (OWNER/CEO)
(618) 310-1499
Entity
Organization
Contact information
Practice address
1632 LEBANON AVE, BELLEVILLE, IL 62221-2466
(618) 310-1499
Mailing address
1632 LEBANON AVE, BELLEVILLE, IL 62221-2466
(618) 310-1499
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700902988
OWNERS NPI
IL
Enumeration date
08/23/2007
Last updated
08/23/2007
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