KENNETH BLACK

MOUNDRIDGE, KS
NPI1073719050
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: KS  14-01477)
Enumeration Date2007-06-26
Last Update Date2007-07-08
Business Address
-- KENNETH BLACK
86TH 22ND AVE MEMORIAL HOME
MOUNDRIDGE, KS 67107-7003
Phone number: 620-345-2901
Mailing Address
-- KENNETH BLACK
900 SPRUCE ST
HALSTEAD, KS 67056-2524
Phone number:
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