Individual
GRACE MARIE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
366 RICHLAND AVE APT 4203B, ATHENS, OH 45701-3258
(302) 381-4941
Mailing address
210 RUSTIC LN, DOVER, DE 19901-8742
(302) 381-4941
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT005627
OH
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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