Individual
DR. CHARLES THOMAS KENNEDY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1578 EASTON AVENUE, BETHLEHEM, PA 18017
(610) 866-4440
(610) 866-5671
Mailing address
1578 EASTON AVENUE, BETHLEHEM, PA 18017
(610) 866-4440
(610) 866-5671
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003479L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015429890005
—
PA
01
—
00278910
BLUE SHIELD
PA
01
—
0266570
BLUE CROSS
PA
Enumeration date
06/30/2005
Last updated
12/13/2013
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