NPI 1548583172

Charles Reggie Kennedy, CERTIFIEDORTHOTIST

Practitioner Orthotist Jackson, MS

Practice location

Address: 777 Lakeland Dr, Jackson, MS 39216-4611
Phone: (601) 815-4844
Mailing address: 503 Cedar St, Mize, MS 39116-5572

Registered specialties

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence C0004097 (MS)

Other Orthotist providers in Mississippi →

Registry record

NPI: 1548583172
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Mar 2010
Record last updated: 10 Mar 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.