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Individual

AMBER LEE KENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT, MTC

Contact information

Practice address
100 EXECUTIVE WAY, SUITE #109, PONTE VEDRA, FL 32082-2715
(904) 543-9011
(904) 543-1390
Mailing address
13019 RIVER SPRINGS WAY, JACKSONVILLE, FL 32224-8506
(904) 219-7881
(904) 543-1390

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15920
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AA175
MEDICARE PTAN
FL
01
P00382647
MEDICARE RAILROAD
FL
Enumeration date
08/15/2006
Last updated
10/31/2007
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