Individual
MICHAEL SHAWN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113262 S 4620 RD, SALLISAW, OK 74955-7991
(918) 315-0315
Mailing address
113262 S 4620 RD, SALLISAW, OK 74955-7991
(918) 315-0315
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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