Individual
DR. JAY MICHAEL KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
808 DIAMOND ST, BERLIN, PA 15530-1539
(814) 267-5830
(814) 267-6103
Mailing address
808 DIAMOND ST, BERLIN, PA 15530-1539
(814) 267-5830
(814) 267-6103
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC003949L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01162738
—
PA
05
—
1508429
—
PA
01
—
2058294
AETNA HMO/POS
PA
01
—
216978
UPMC
PA
01
—
4281751
AETNA PPO
PA
05
—
93492
—
PA
01
—
BA1489298
BCBS
PA
01
—
KE469395
BCBS
PA
Enumeration date
01/06/2006
Last updated
02/13/2008
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