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General NPI Number Information
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NPI Number | 1710050604
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Entity Type | Individual
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Provider Name | ROBERT CLAIR KENNY DC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7970 M 68
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City | INDIAN RIVER
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State | MI
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Zip | 49749-9324
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Country | US
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Telephone | 231-238-6951
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Fax | 231-238-0197
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Provider Business Mailing Address
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Address Line | 7970 M 68
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City | INDIAN RIVER
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State | MI
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Zip | 49749-9324
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Country | US
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Telephone | 231-238-6951
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Fax | 231-238-0197
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1961
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License Number State | MI
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