Individual
KENNETH FRANKLIN YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
4119 TYRONE WAY, CARMICHAEL, CA 95608-1656
(540) 597-8165
Mailing address
4119 TYRONE WAY, CARMICHAEL, CA 95608-1656
(540) 597-8165
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
920347
VA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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