Individual
KENNETH MCENTEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1818 E REZANOF DR, KODIAK, AK 99615-6505
(815) 412-5476
Mailing address
352 LILLY DR # 108, KODIAK, AK 99615-7115
(815) 412-5476
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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