MR. Kenneth John Bannon, BSPA-C
NPI #1821055047 in Carbondale, Pennsylvania
Provider Information
- NPI Number
- 1821055047
- Entity Type
- Individual
- Name
- MR. Kenneth John Bannon, BSPA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- BSPA-C
- Enumeration Date
- May 1, 2006
- Last Updated
- Mar 23, 2015
Practice Location
- Address
- 111 SALEM AVENUE
- Address 2
- SUITE 302
- City
- Carbondale
- State
- Pennsylvania
- ZIP Code
- 18407-2574
- Phone
- (570) 282-2031
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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