Doctor Name: | MRS. TONJA KENNEDY |
NPI Number: | 1114323417 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1061 Harmon Ave Fort Stewart, GA - 313145641 |
Business Phone Number: | 9124356362 |
Business Fax Number: | |
Mailing Address: | 2463 Dd Durrence Rd, GLENNVILLE |
State: | GA |
Postal Code: | 304278212 |
Phone Number: | 9126541629 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2014 |
NPI Last Update Date: | 11/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |