Individual
KENNY JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7106 IVY CHASE WAY NE, ATLANTA, GA 30342-4253
(313) 200-4543
Mailing address
7106 IVY CHASE WAY NE, ATLANTA, GA 30342-4253
(313) 200-4543
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
171W00000X
Contractor
Primary
—
—
172A00000X
Driver
—
—
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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