| Doctor Name: | JOSEPH A KENNEDY |
| NPI Number: | 1013087063 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OTHER |
| License Number: | 1117 |
| Business Practice Address: | 902 E Lincoln Rd Idabel, OK - 747457337 |
| Business Phone Number: | 5802862600 |
| Business Fax Number: | 5802861107 |
| Mailing Address: | 107 Miles St, BROKEN BOW |
| State: | OK |
| Postal Code: | 747284507 |
| Phone Number: | 5802365261 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2006 |
| NPI Last Update Date: | 06/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |