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General NPI Number Information
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NPI Number | 1942538525
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Entity Type | Individual
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Provider Name | ALYSSA RENEE KENYON D. C.
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Gender | Female
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 351 S US HIGHWAY 1
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City | JUPITER
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State | FL
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Zip | 33477-5993
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Country | US
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Telephone | 917-627-0344
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 SE FEDERAL HWY UNIT 104
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City | STUART
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State | FL
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Zip | 34997-5760
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Country | US
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Telephone | 772-286-1720
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Fax | 772-286-7141
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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 | CH9692
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License Number State | FL
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