Individual
KENNETH WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11937 CHESTER CREEK RD, JACKSONVILLE, FL 32218-3314
(904) 382-4388
Mailing address
11937 CHESTER CREEK RD, JACKSONVILLE, FL 32218-3314
(904) 382-4388
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/22/2015
Last updated
02/22/2015
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