Individual
ANTHONY KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7211 W FRANKLIN RD, BOISE, ID 83709-0926
(701) 341-1569
Mailing address
115 BREWSTER ST W, HARVEY, ND 58341-1518
(701) 341-1569
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT - 1570
ID
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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