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1407569817
KENNY CHRYSOSTOME
LAWRENCEVILLE, GA
NPI
1407569817
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: FL 9461936)
Enumeration Date
2022-12-30
Last Update Date
2022-12-30
Business Address
KENNY CHRYSOSTOME
175 GWINNETT DR
LAWRENCEVILLE, GA 30046-8444
Phone number: 678-209-2394
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Mailing Address
KENNY CHRYSOSTOME
115 JAY CT
ROYAL PALM BEACH, FL 33411-1723
Phone number: 561-797-9787
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