Individual
KENNETH BLIND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
47 DORCLIN LN, SAINT LOUIS, MO 63128-1426
(314) 467-0901
Mailing address
47 DORCLIN LN, SAINT LOUIS, MO 63128-1426
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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