Individual
KUNTA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2024 W OGLETHORPE AVE APT 15, ALBANY, GA 31707-4162
(229) 291-8311
Mailing address
2024 W OGLETHORPE AVE APT 15, ALBANY, GA 31707-4162
(229) 291-8311
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
047597856
GA
172A00000X
Driver
Primary
047597856
GA
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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