MICHAEL P KAVANAGH

FORT BENNING, GA
NPI1619032497
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy222Z00000X Orthotist
(Licence: GA  34)
Additional Taxonomies224P00000X Prosthetist
(Licence: GA  34)
Enumeration Date2006-12-22
Last Update Date2019-09-17
Business Address
Mr. MICHAEL P KAVANAGH CPO
6600 VAN AALST BLVD
FORT BENNING, GA 31905-2102
Phone number: 762-408-1467
Mailing Address
Mr. MICHAEL P KAVANAGH CPO
125 PERRYS MILL RD
PINE MOUNTAIN, GA 31822-5112
Phone number: 706-663-9715