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Individual

KENNEDY HENRY THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
406 E MAIN ST, ADA, MN 56510
(218) 784-2330
(218) 784-2331
Mailing address
406 E MAIN ST, ADA, MN 56510
(218) 784-2330
(218) 784-2331

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1429
MN
111N00000X
Chiropractor
724
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
680527200
MN
Enumeration date
09/05/2006
Last updated
07/28/2010
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