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NPI Code Detail

MEDICARE: MAKAYLA LEE KENNEDY MSOT, OTR/L

MEDICARE: MAKAYLA LEE KENNEDY MSOT, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist7146TN

General Provider Information

NPI Number : 1235890401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKAYLA LEE KENNEDY MSOT, OTR/L
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7568
Fax Number :
Provider Business Practice Location Address
First Line : 8905 TOWN AND COUNTRY CIR STE 9
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4931
Country : US
Telephone Number : 865-539-9185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2022
Last Update Date : 01/10/2022

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