Individual
KENNEDY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7219 W POTOMAC DR, BOISE, ID 83704-9182
(208) 908-8540
Mailing address
4704 W CAMAS ST, BOISE, ID 83705-5833
(253) 359-3263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-8919
ID
225100000X
Physical Therapist
PT016185
GA
Other
Enumeration date
08/23/2022
Last updated
10/11/2023
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