Provider Demographics
NPI:1265166748
Name:FRANCIS, KENNETH JR (HAIR REPLACEMENT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:FRANCIS
Suffix:JR
Gender:M
Credentials:HAIR REPLACEMENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 SHARONBROOK DR UNIT H
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-0192
Mailing Address - Country:US
Mailing Address - Phone:904-452-3837
Mailing Address - Fax:
Practice Address - Street 1:7643 PINEVILLE MATTHEWS RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3909
Practice Address - Country:US
Practice Address - Phone:904-452-3837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
No1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty