Individual provider · NPI-1

Mary Eleanor Kennedy, pta

Physical Medicine & Rehabilitation · Okemos, MI

NPI number1891093761
StatusActive
Last updated in NPPESNov 21, 2013

Details

NPI
1891093761
Entity type
Individual (NPI-1)
Name
Mary Eleanor Kennedy
Credential
pta
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 2, 2011
Last updated
Nov 21, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation5502001417MIYes

Practice location

5211 Marsh Rd
Okemos, MI 48864-1106

Phone 517-319-1400

Mailing address

5211 Marsh Rd
Okemos, MI 48864-1106

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