Individual
KEVIN GARY DESNOYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4895 PINE RIDGE DR, COLUMBUS, IN 47201-2569
(812) 342-2148
Mailing address
4486 PRINCETON PARK DR, COLUMBUS, IN 47201-2809
(812) 375-0895
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008528A
IN
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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