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Individual

MR. KENNETH WAYNE HARBOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.R.A, R.T.(R)

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0111
Mailing address
649 TURKEY CRK, ALACHUA, FL 32615-9309

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
CRT54343
FL
243U00000X
Radiology Practitioner Assistant
Primary
RA28
FL

Other

Enumeration date
04/19/2012
Last updated
04/19/2012
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