Individual
BRIAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
576 HAWTHORNE WOODS DR, EAGAN, MN 55123-3059
(651) 270-4218
Mailing address
576 HAWTHORNE WOODS DR, EAGAN, MN 55123-3059
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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