Individual
NATHAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8350 3RD AVE UNIT 284, FORT RUCKER, AL 36362-2039
(909) 519-6870
Mailing address
8350 3RD AVE UNIT 284, FORT RUCKER, AL 36362-2039
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E1914789
AL
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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