KENNETH ORDIZ MUTIA

FORT DRUM, NY
NPI1518792704
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2024-09-06
Last Update Date2025-12-16
Business Address
KENNETH ORDIZ MUTIA
11050 MT BELVEDERE BLVD
FORT DRUM, NY 13602-2603
Phone number: 315-772-8813
Mailing Address
KENNETH ORDIZ MUTIA
8640 PECK ST
EVANS MILLS, NY 13637-7709
Phone number: 914-522-6001
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