Individual
JANE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
8601 N BLACK CANYON HWY STE 103, PHOENIX, AZ 85021-4155
(602) 628-6636
Mailing address
11225 N 16TH AVE, PHOENIX, AZ 85029-3757
(602) 628-6636
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-04684P
AZ
Other
Enumeration date
09/28/2015
Last updated
08/17/2020
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