Individual
STEVEN L KENYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9368 S 150 W, BROOKSTON, IN 47923-8059
(765) 563-6163
Mailing address
9368 S 150 W, BROOKSTON, IN 47923-8059
(765) 563-6163
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
200878950A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200878950A
—
IN
Enumeration date
08/26/2008
Last updated
08/26/2008
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