Individual
DR. JOHN KENNEDY
Active
Individual
DR. JOHN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
1795
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11287
BCBS OF AL PROVIDER NO.
AL
01
—
271006696
TAX ID
AL
Enumeration date
02/20/2007
Last updated
07/22/2013
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