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Individual

DR. KENT H KIENLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
401 S BENT ST STE B, POWELL, WY 82435-2837
(307) 754-7254
(307) 754-5937
Mailing address
401 S BENT ST STE B, POWELL, WY 82435-2837
(307) 754-7254
(307) 754-5937

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WY-189T
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119393700
WY
Enumeration date
10/02/2006
Last updated
05/14/2015
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