Organization
KENNERLY SURGICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R MICHAEL KENNERLY MD (MD)
(304) 521-2230
Entity
Organization
Contact information
Practice address
809 WILLOW LN, PT PLEASANT, WV 25550-2018
(304) 521-2230
Mailing address
809 WILLOW LN, PT PLEASANT, WV 25550-2018
(304) 521-2230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2239-0413
WV
Other
Enumeration date
04/30/2010
Last updated
04/30/2010
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