Individual
NIKKI KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 CASTLEMAN ROAD, CARROLLTON, GA 30116
(770) 830-6535
(770) 830-6271
Mailing address
115 CASTLEMAN ROAD, CARROLLTON, GA 30116
(770) 830-6535
(770) 830-6271
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
GA
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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