Doctor Name: | DR. TIMOTHY MICHAEL KENNEDY |
NPI Number: | 1750787586 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | CH11346 |
Business Practice Address: | 500 Se Dixie Hwy #2 Stuart, FL - 349943054 |
Business Phone Number: | 5613421577 |
Business Fax Number: | |
Mailing Address: | 318 Se Fisk Rd, PORT ST LUCIE |
State: | FL |
Postal Code: | 349848920 |
Phone Number: | 8608835850 |
Fax Number: | |
NPI Enumeration Date: | 11/05/2014 |
NPI Last Update Date: | 11/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CH11346 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |