Individual
TERRY G KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1822 W LINCOLN ST STE 1, BOZEMAN, MT 59715-5410
(406) 585-4642
(406) 585-2878
Mailing address
1822 W LINCOLN ST STE 1, BOZEMAN, MT 59715-5410
(406) 585-4642
(406) 585-2878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1579
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1579
STATE OF MT PHYSICAL THERAPY LICENSE #1579
MT
Enumeration date
09/08/2008
Last updated
09/08/2008
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