Individual
BRENT DUANE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12884 S 600 W, HANNA, IN 46340-9788
(219) 405-8509
(219) 733-2561
Mailing address
12884 S 600 W, HANNA, IN 46340-9788
(219) 405-8509
(219) 733-2561
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
8960520176
IN
Other
Enumeration date
08/22/2010
Last updated
08/22/2010
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