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1730320805
CHARLES M KENNEDY
DALLAS, OR
NPI
1730320805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: OR 97-04-91)
Enumeration Date
2009-03-18
Last Update Date
2009-03-18
Business Address
Mr. CHARLES M KENNEDY NCAC II
171 SW COURT ST
DALLAS, OR 97338-3112
Phone number: 503-831-1423
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Mailing Address
Mr. CHARLES M KENNEDY NCAC II
171 SW COURT ST
DALLAS, OR 97338-3112
Phone number: 503-831-1423
Copy
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