Individual
KEIA C KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-7355
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-7355
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051988
PA
Other
Enumeration date
01/31/2008
Last updated
01/22/2013
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