Individual
KENNY LAURENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 HOOVER AVE, BLOOMFIELD, NJ 07003-3918
(954) 892-3489
Mailing address
345 HOOVER AVE, BLOOMFIELD, NJ 07003-3918
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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