Individual
KEVIN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 S LAKE ST, EAST JORDAN, MI 49727-9375
(231) 675-8228
Mailing address
5345 WEBSTER BRIDGE RD, EAST JORDAN, MI 49727-9673
(231) 675-8228
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401002334
MI
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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