KEN O RIDGEWAY

GREENTOWN, IN
NPI1013998723
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  2000340)
Enumeration Date2005-11-09
Last Update Date2007-10-24
Business Address
-- KEN O RIDGEWAY DO
712 W MAIN ST
GREENTOWN, IN 46936-1045
Phone number: 765-628-3319
Mailing Address
-- KEN O RIDGEWAY DO
712 W MAIN ST
GREENTOWN, IN 46936-1045
Phone number: 765-628-3319
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