KENNETH CHARLES DEAN

SHREVEPORT, LA
NPI1184188435
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225XG0600X Occupational Therapist, Gerontology
(Licence: TX  214817)
Enumeration Date2019-01-30
Last Update Date2019-01-30
Business Address
KENNETH CHARLES DEAN COTA/L
8924 BAYONNE DR
SHREVEPORT, LA 71118-2033
Phone number: 318-294-1952
Mailing Address
KENNETH CHARLES DEAN COTA/L
127 W BROAD ST
LAKE CHARLES, LA 70601-4393
Phone number:
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