Individual
TIMOTHY MICHAEL KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 RIVERTON COMMONS DR, FRONT ROYAL, VA 22630-6718
(540) 551-8157
Mailing address
10 RIVERTON COMMONS DR, FRONT ROYAL, VA 22630-6718
(540) 551-8157
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101002006
VA
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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