Individual
MR. WILTON CRAIG KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2620 AVENHAM AVE SW, ROANOKE, VA 24014-1507
(540) 985-4016
Mailing address
2620 AVENHAM AVE SW, ROANOKE, VA 24014-1507
(540) 985-4016
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110 001184
VA
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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