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Individual

ANTHONY T KENNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
4223 ORANGE BEACH BLVD, SUITE D, ORANGE BEACH, AL 36561-3459
(251) 981-1300
(251) 981-1305
Mailing address
1908 FLINT RD SE, DECATUR, AL 35601-6031
(256) 340-9708
(256) 340-9624

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH1955
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003819608
GROUP NPI
AL
05
529917620
AL
01
DB9027
RAILROAD MEDICARE GROUP
AL
Enumeration date
07/26/2006
Last updated
03/27/2009
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