Individual
DR. MITCH L KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.D.
Contact information
Practice address
46 W AVON RD, SUITE 202, AVON, CT 06001-3679
(860) 673-9954
(860) 673-4063
Mailing address
85 ARCH RD, AVON, CT 06001-4206
(860) 712-4792
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
000245
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000245
STATE OF CT LICENSE NO.
CT
Enumeration date
02/22/2007
Last updated
07/08/2007
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