Individual
CYNTHIA MARY KENNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
131 W 8TH ST, WYOMING, PA 18644-1607
(570) 693-9393
(570) 693-2703
Mailing address
131 W 8TH ST, WYOMING, PA 18644-1607
(570) 693-9393
(570) 693-2703
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC004703L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001432305001
—
PA
01
—
691197
BLUE SHIELD
PA
Enumeration date
10/06/2006
Last updated
12/02/2011
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