Individual
JEFF KANGETHE KANINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 217, BROCKTON, MA 02303-0217
(617) 642-7594
Mailing address
PO BOX 217, BROCKTON, MA 02303-0217
(617) 642-7594
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN88608
MA
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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