Organization
KENNIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL J RAVEY (OWNER)
(225) 273-1891
Entity
Organization
Contact information
Practice address
12097 OLD HAMMOND HWY, SUITE D4, BATON ROUGE, LA 70816-8679
(225) 273-1891
(225) 273-1892
Mailing address
12097 OLD HAMMOND HWY, SUITE D4, BATON ROUGE, LA 70816-8679
(225) 273-1891
(225) 273-1892
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
50362
LA
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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