Individual
MR. JUSTIN DWAYNE KENNEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
385 HIGHWAY 65 N, CONWAY, AR 72032-3506
(501) 697-9881
Mailing address
331 S BOLDEN HILL RD, GREENBRIER, AR 72058-9024
(817) 688-5865
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR2937
AR
Other
Enumeration date
11/12/2018
Last updated
01/03/2022
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