Individual
KENNETH ROY PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE
Contact information
Practice address
127 CLOUDHAVEN DR, SAN ANTONIO, TX 78209-4339
(210) 319-0041
Mailing address
8611 MONTEREY FLS, BOERNE, TX 78015-2106
(210) 884-4483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
578178
TX
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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