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General NPI Number Information
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NPI Number | 1679715684
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Entity Type | Organization
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Legal Business Name | ROB J KENNEDY PLLC
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 185 PASADENA DR STE #110
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City | LEXINGTON
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State | KY
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Zip | 40503-2969
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Country | US
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Telephone | 859-275-1962
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Fax | 859-275-1966
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Provider Business Mailing Address
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Address Line | 185 PASADENA DRIVE STE #110
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City | LEXINGTON
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State | KY
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Zip | 40503
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Country | US
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Telephone | 859-275-1962
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Fax | 859-275-1966
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | ROB JOSEPH KENNEDY
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Credential | D.C
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Telephone | 859-275-1962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5156
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License Number State | KY
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