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1104167972
KENNETH JOE TALLEY
KENNETT, MO
NPI
1104167972
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
247200000X Technician, Other
Enumeration Date
2013-03-04
Last Update Date
2013-03-04
Business Address
Mr. KENNETH JOE TALLEY
1109 JONES ST
KENNETT, MO 63857-3824
Phone number: 573-888-6545
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Mailing Address
Mr. KENNETH JOE TALLEY
1109 JONES ST PO BOX 470
KENNETT, MO 63857-3824
Phone number: 573-888-6545
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