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Individual

MR. MACK HENRY KENNEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
406 ROYAL CREST CIR, KATHLEEN, GA 31047-2169
(770) 374-7110
Mailing address
103 COLLETON DR, ATHENS, GA 30606-7831
(706) 206-2964

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
052745615
GA

Other

Enumeration date
05/05/2023
Last updated
05/05/2023
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