Individual
FREDRICK DONIAL KENNEDY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2650 CAMINO DEL RIO N STE 201, SAN DIEGO, CA 92108-1631
(619) 340-2096
Mailing address
6888 FRIARS RD APT 219, SAN DIEGO, CA 92108-1168
(229) 299-1533
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
53236
CA
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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