Individual
BRIAN DAVID KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
223 S LAKESHORE DR, LAKE CITY, MN 55041-1642
(651) 345-3411
(651) 345-4848
Mailing address
30151 715TH ST, LAKE CITY, MN 55041-5002
(651) 345-5010
(651) 345-1158
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115760-6
MN
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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