Individual
JACOB THOMAS KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4921 AIRLINE DR, METAIRIE, LA 70001-5664
(504) 889-2663
Mailing address
4921 AIRLINE DR, METAIRIE, LA 70001-5664
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A10437
LA
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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