Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 21953 | MN |
NPI | 1013119007 |
---|---|
Provider Name | Dr. Terence James Kennedy |
First Address | Alexandria, MN 56308-9376 |
Second Address | Alexandria, MN 56308-9376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2007 |
Last Update Date | 08/07/2007 |