Individual
GARY MARTIN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 PAVILION PKWY, FAYETTEVILLE, GA 30214-4056
(770) 460-4106
(770) 716-0674
Mailing address
108 PAVILION PKWY, FAYETTEVILLE, GA 30214
(770) 460-4106
(770) 716-0674
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013651
GA
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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