Individual
KENNETH A GOSNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CH
Contact information
Practice address
120 STRODE CIR, CLEMSON, SC 29631-1484
(864) 624-9355
(864) 624-9356
Mailing address
PO BOX 1007, CLEMSON, SC 29633-1007
(864) 624-9355
(864) 624-9356
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2047
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH2047
—
SC
05
—
GCH130
—
SC
Enumeration date
10/18/2005
Last updated
10/21/2010
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