KENNETH BLAKE DEBORD

REIDSVILLE, NC
NPI1235255738
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: NC  2226)
Enumeration Date2007-03-22
Last Update Date2007-07-08
Business Address
MR. KENNETH BLAKE DEBORD PTA
618 S MAIN ST
REIDSVILLE, NC 27320-5020
Phone number: 336-951-4557
Mailing Address
MR. KENNETH BLAKE DEBORD PTA
1921 NEW GARDEN RD APT J305
GREENSBORO, NC 27410-2193
Phone number: 336-880-1295
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