Provider Demographics
NPI:1073000147
Name:KENNEDY, JOE DANIEL (DC)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:DANIEL
Last Name:KENNEDY
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 SCHOOLHOUSE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3776
Mailing Address - Country:US
Mailing Address - Phone:817-251-1637
Mailing Address - Fax:
Practice Address - Street 1:1090 SCHOOLHOUSE RD STE 500
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3776
Practice Address - Country:US
Practice Address - Phone:817-251-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-15
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty