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1164665907
KENNETH ALAN MOON
MARIPOSA, CA
NPI
1164665907
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-04-09
Last Update Date
2009-04-09
Business Address
-- KENNETH ALAN MOON
5037 STROMING RD
MARIPOSA, CA 95338
Phone number: 209-966-2000
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Mailing Address
-- KENNETH ALAN MOON
PO BOX 99
MARIPOSA, CA 95338-0099
Phone number: 209-966-2000
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