Individual
KENNETH L VIRGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(949) 874-7806
Mailing address
902 N 21ST ST APT 6, LAFAYETTE, IN 47904-2264
(949) 874-7806
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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