Individual
SHELLY KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2924 SANTA CLARA AVE SE, ALBUQUERQUE, NM 87106-2947
(505) 515-7748
Mailing address
2924 SANTA CLARA AVE SE, ALBUQUERQUE, NM 87106-2947
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTA1508
NM
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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