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General NPI Number Information
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NPI Number | 1720091994
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Entity Type | Individual
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Provider Name | LEO MICHAEL KENNEY D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3316 WHITE MOUNTAIN HIGHWAY
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City | NORTH CONWAY
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State | NH
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Zip | 03860-5189
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Country | US
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Telephone | 603-356-2471
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Fax | 603-356-8759
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Provider Business Mailing Address
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Address Line | PO BOX 3
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City | NORTH CONWAY
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State | NH
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Zip | 03860-0003
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Country | US
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Telephone | 603-356-2471
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Fax | 603-356-8759
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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 | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 128-0655-0184A
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 565
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 896288
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License Number State | MA
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