Individual
DR. CYNTHIA Z KENNEALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1040 N MASON RD, SUITE 219, SAINT LOUIS, MO 63141-6399
(314) 275-2020
(314) 275-8719
Mailing address
660 S EUCLID AVE, C B 8096, SAINT LOUIS, MO 63110-1010
(314) 275-2020
(314) 275-8719
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R2D39
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202473419
—
MO
Enumeration date
07/18/2006
Last updated
08/12/2010
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