Individual
MS. MARIA BASILIO KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1315 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4121
(336) 917-6000
(336) 917-6003
Mailing address
1315 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4121
(336) 917-6000
(336) 917-6003
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5686
NC
225200000X
Physical Therapy Assistant
A5686
NC
Other
Enumeration date
07/31/2015
Last updated
07/21/2022
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