Individual
THOMAS CHARLES KINNE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 ASPEN STREET, FREDONIA, AZ 86022
(928) 925-5992
Mailing address
PO BOX 491, FREDONIA, AZ 86022-0491
(928) 925-5992
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
8876774
AZ
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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