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1972617355
KENNETH JOHN SUPPES
SAGINAW, MI
NPI
1972617355
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: MI 4901002383)
Enumeration Date
2006-08-19
Last Update Date
2007-07-08
Business Address
-- KENNETH JOHN SUPPES OD
1885 N CENTER RD
SAGINAW, MI 48638-5565
Phone number: 989-792-6627
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Mailing Address
-- KENNETH JOHN SUPPES OD
1885 N CENTER RD
SAGINAW, MI 48638-5565
Phone number: 989-792-6627
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