Individual
LAUREN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
120 ELZORA ST, MILTON FREEWATER, OR 97862-9454
(541) 938-3318
Mailing address
502 OLD BRIDGE RD, WARNER ROBINS, GA 31088-1190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013012
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63452
OREGON PHYSICAL THERAPY LICENSE
OR
01
—
PT013012
PHYSICAL THERAPY LICENSE
GA
Enumeration date
08/08/2017
Last updated
10/13/2019
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