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Individual

MRS. KENNA LAINE WARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AP, DOM

Contact information

Practice address
1340 TUSKAWILLA RD STE 111, WINTER SPRINGS, FL 32708-5030
(407) 782-1934
Mailing address
2939 WILLOW BAY TER, CASSELBERRY, FL 32707-6735
(407) 782-1934

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP565
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102471100
FL
Enumeration date
06/13/2006
Last updated
08/14/2020
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