Individual
LARRY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
389 SW SCALEHOUSE CT STE 130, BEND, OR 97702-3241
(541) 306-4446
(541) 550-2011
Mailing address
389 SW SCALEHOUSE CT STE 130, BEND, OR 97702-3241
(541) 306-4446
(541) 550-2011
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-CRM-2944
OR
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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