Individual
MR. KEVIN MICHAEL MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, LPTA
Contact information
Practice address
2813 W 17TH ST, WILMINGTON, DE 19806-1112
(302) 722-0406
Mailing address
1319 WOODLAWN AVE, WILMINGTON, DE 19806-2445
(302) 575-0550
(302) 657-8373
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J3-0000118
DE
246Z00000X
Other Specialist/Technologist
J2-0000138
DE
Other
Enumeration date
02/21/2007
Last updated
09/11/2025
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