Individual
KENNETH HARDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11401 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32258-1402
(858) 229-6768
Mailing address
11401 RIVERGARDEN, JACKSONVILLE, FL 32253
(858) 229-6768
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25700
FL
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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