Search › Pennsylvania › 363A00000X
Kenneth Bannon, BSPA-C
NPI 1821055047 · on the registry since 2006
Practice
- Address
- 111 Salem Avenue
Suite 302
Carbondale, PA 18407 - Phone
- (570) 282-2031
- Fax
- (570) 282-2534
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-03-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania