Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0108802770 | VA |
NPI | 1043547920 |
---|---|
Provider Name | Christopher Kenny |
First Address | Harker Heights, TX 76548-8653 |
Second Address | Fort Hood, TX 76544-5095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 09/10/2013 |