Provider Demographics
NPI:1902338205
Name:KENNY, LEVI (DC)
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:
Last Name:KENNY
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 1:214 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1902
Mailing Address - Country:US
Mailing Address - Phone:402-375-3000
Mailing Address - Fax:402-375-1866
Practice Address - Street 1:214 N PEARL ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1902
Practice Address - Country:US
Practice Address - Phone:402-375-3000
Practice Address - Fax:402-375-1866
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor