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1053637215
MARK GREGORY KINNAMAN
COUNCIL BLUFFS, IA
NPI
1053637215
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-04-13
Last Update Date
2010-04-13
Business Address
-- MARK GREGORY KINNAMAN CADC
933 E PIERCE ST
COUNCIL BLUFFS, IA 51503-4626
Phone number: 712-396-4387
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Mailing Address
-- MARK GREGORY KINNAMAN CADC
933 E PIERCE ST
COUNCIL BLUFFS, IA 51503-4626
Phone number: 712-396-4387
Copy
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