Individual
BRUCE ERIC KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
351 ALABAMA RD, ADEL, GA 31620-3818
(229) 896-9994
(229) 896-9996
Mailing address
351 ALABAMA RD, ADEL, GA 31620-3818
(229) 896-9994
(229) 896-9996
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO2544
GA
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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