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Organization

ARIS IOP LLC

Active
Parent organization
RAYMOND J KENNEDY MD PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
RAYMOND J KENNEDY MD PA
Authorized official
SHALENE KENNEDY M.D. (OWNER)
(651) 259-9750
Entity
Organization

Contact information

Practice address
7616 CURRELL BLVD STE 100, WOODBURY, MN 55125-2295
(651) 259-9750
Mailing address
7616 CURRELL BLVD STE 100, WOODBURY, MN 55125-2295
(651) 259-9750

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
08/08/2011
Last updated
08/08/2011
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