Individual
DR. KENNETH JASON PROEFROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NMD
Contact information
Practice address
14991 W BELL RD, SURPRISE, AZ 85374-3874
(623) 977-0077
(623) 977-0057
Mailing address
14991 W BELL RD, SURPRISE, AZ 85374-3874
(623) 977-0077
(623) 977-0057
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
96-481
AZ
171100000X
Acupuncturist
96-481
AZ
175F00000X
Naturopath
Primary
96-481
AZ
175L00000X
Homeopath
96-481
AZ
Other
Enumeration date
12/11/2006
Last updated
03/07/2023
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