Individual
MR. KENNEDY EDWARD ANOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9500 SW BARBUR BLVD, SUITE 115, PORTLAND, OR 97219-5466
(503) 781-8729
Mailing address
9500 SW BARBUR BLVD, SUITE 115, PORTLAND, OR 97219-5466
(503) 781-8729
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
14012
OR
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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