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General NPI Number Information
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NPI Number | 1780902387
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Entity Type | Organization
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Legal Business Name | ROBERT C KENNY DC PC
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 05/07/2010
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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 | 49749-9041
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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 | 49749-9041
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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 | OWNER
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Name | DR. ROBERT CLAIRE KENNY
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Credential | DC
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Telephone | 231-238-6951
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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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