Most Relevant Information
Provider Data
| NPI Number: | 1003543042 |
| Provider Name: | KENNEDY ALISE GRAVES |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2022 |
| Last Updated: | 08/01/2022 |
Provider Practice Location
615 IRVING SCHOTTENSTEIN DR
COLUMBUS
OH
432101069
Practice Location Phone/Fax
| Phone: | 6142931634 |
| Fax: |
Provider Mailing Location
9739 TROON CT
BLUE ASH
OH
452413349
Provider Mailing Phone/Fax
| Phone: | 5134842822 |
| Fax: |