Robert Clair Kenny, DC

Individual provider Active NPI Chiropractor · Indian River, MI

NPI 1710050604 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710050604
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1961 (MI)
Practice address
7970 M 68
Indian River, MI 49749-9324
Phone
(231) 238-6951
Fax
(231) 238-0197
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1961MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Human Services Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1961 MI Yes

Addresses

Primary practice location

7970 M 68
Indian River, MI 49749-9324

Mailing address

7970 M 68
Indian River, MI 49749-9324
Phone (231) 238-6951

Other identifiers

IdentifierTypeStateIssuer
1001951MedicaidMI

Other providers in Indian River, MI

All providers in Indian River, MI · Chiropractor in Michigan

Sources for this page

Verify at the official NPI Registry.