Individual
BRIAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1423 N JEFFERSON AVE, B100, SPRINGFIELD, MO 65802
(417) 269-8787
(417) 269-8744
Mailing address
1423 N JEFFERSON AVE # B100, SPRINGFIELD, MO 65802-1917
(417) 269-8787
(417) 269-8744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2017022156
MO
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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