Individual
KENNEDY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5217 HOLTON WHITEHALL RD, HOLTON, MI 49425-7503
(231) 683-8009
Mailing address
5217 HOLTON WHITEHALL RD, HOLTON, MI 49425-7503
(231) 683-8009
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202009919
MI
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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