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General NPI Number Information
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NPI Number | 1982840716
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Entity Type | Individual
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Provider Name | KODY D KENNINGTON AU.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1100 COUNTRY HILLS DR 200
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City | OGDEN
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State | UT
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Zip | 84403-2503
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Country | US
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Telephone | 801-399-5014
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Fax |
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Provider Business Mailing Address
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Address Line | 985 W 7850 S
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City | WILLARD
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State | UT
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Zip | 84340-6701
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Country | US
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Telephone | 435-734-9197
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 5159751-4101
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License Number State | UT
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