Provider Demographics
NPI:1497906184
Name:KENNEDY, ROBBIE JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBBIE
Middle Name:JOSEPH
Last Name:KENNEDY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 PASADENA DR
Mailing Address - Street 2:STE 110
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2969
Mailing Address - Country:US
Mailing Address - Phone:859-275-1962
Mailing Address - Fax:
Practice Address - Street 1:340 LEGION DR STE 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2716
Practice Address - Country:US
Practice Address - Phone:859-275-1962
Practice Address - Fax:859-275-1966
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor