Individual
MR. MARK KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3524
Mailing address
7703 W SHADOW LAKES ST, WICHITA, KS 67205-1913
(316) 425-0692
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
24-00513
KS
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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