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Individual

MR. KEVIN P KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.P.

Contact information

Practice address
1100 GARDEN HWY., STE. 900, YUBA CITY, CA 95991-7598
(530) 673-6913
(530) 671-6915
Mailing address
551 S BOLLING RD, PAHRUMP, NV 89048-4642
(702) 468-2376
(702) 823-1336

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
ABCCP003164BOCC15566
AK
224P00000X
Prosthetist
Primary

Other

Enumeration date
06/13/2008
Last updated
03/25/2013
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