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Individual

LOGAN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
3308 E WILSON ST, FARMVILLE, NC 27828-1674
(252) 753-5138
Mailing address
3800 BOSTIC DR. GREENVILLE, NC 27834, APT. 3710-103 C, GREENVILLE, NC 27834
(910) 290-3247

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-4615
NC

Other

Enumeration date
05/19/2021
Last updated
05/19/2021
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