Individual
TIFFANY C KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
1267 ENTERPRISE WAY NW STE 2, HUNTSVILLE, AL 35806-4472
(256) 713-1872
(256) 713-1872
Mailing address
1267 ENTERPRISE WAY NW STE 2, HUNTSVILLE, AL 35806-4472
(256) 713-1872
(256) 713-1873
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4990
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51117973
BCBS
—
Enumeration date
10/09/2007
Last updated
07/12/2021
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