Kennedy, Mitch L

Kennedy, Mitch L is an sole proprietor health care provider with primary practice located at 46 W Avon Rd Suite 202, Avon CT 06001-3679. He recently has only one registered license in Other Service Providers / Naturopath, which is considered as his primary health care specialty. Kennedy, Mitch L can be contacted via phone (860) 673-9954.

Contact Information

Primary practice address
46 W Avon Rd Suite 202 Avon CT 06001-3679
Fax: (860) 673-4063
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X 000245 Connecticut

Profile Details

NPI number 1386779346
LBN Legal business name Kennedy, Mitch L
Credentials N.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386779346 NPPES
Connecticut Other 000245 STATE OF CT LICENSE NO.

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