Individual
MR. KEVIN DAVID MENSENDIEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4200 S FALCON DR, BLOOMINGTON, IN 47403-9048
(812) 824-7517
Mailing address
4200 S FALCON DR, BLOOMINGTON, IN 47403-9048
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002786A
IN
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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