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Individual

KENNEDY HARRISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15285 STONES THROW CIR, HAMMOND, LA 70401-7544
(985) 789-9290
Mailing address
255 RUE JONATHAN, SLIDELL, LA 70461-5441

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LA
2255A2300X
Athletic Trainer

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5811132333952
LA
Enumeration date
03/03/2019
Last updated
03/03/2019
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