Individual
MR. JOHN EDWARD KENNEDY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
210 WASHINGTON ST, WAUSAU, WI 54403-5543
(715) 845-3637
Mailing address
210 WASHINGTON ST, WAUSAU, WI 54403-5543
(715) 571-1343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
193347-30
WI
Other
Enumeration date
04/08/2013
Last updated
09/26/2016
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