Individual
STACEY C KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HOLLISTON PEDIATRIC GROUP, 100 JEFFREY AVE., HOLLISTON, MA 01746
(508) 429-2800
Mailing address
HOLLISTON PEDIATRIC GROUP, 100 JEFFREY AVE., HOLLISTON, MA 01746
(508) 429-2800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
73391
MA
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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