MEDICARE: DR. MICHAEL KENNY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC003850L	PA

General Provider Information

NPI Number	:	1538167093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL KENNY D.C.

Provider Business Mailing Address
First Line	:	15 AUBURN DR
Second Line	:
City	:	RICHBORO
State	:	PA
Zip	:	18954-1269
Country	:	US
Telephone Number	:	215-332-4770
Fax Number	:	215-332-5057

Provider Business Practice Location Address
First Line	:	7439 FRANKFORD AVE
Second Line	:	SUITE B1
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-3600
Country	:	US
Telephone Number	:	215-332-4770
Fax Number	:	215-332-5057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/22/2010

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