Individual
NICHOLAS KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1112 S PORTER ST, KIRKSVILLE, MO 63501-1671
(417) 499-7736
Mailing address
1112 S PORTER ST, KIRKSVILLE, MO 63501-1671
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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