Individual
KENNETH J. FENIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 LINDSAY CT, ELYRIA, OH 44035-8857
(440) 213-3822
Mailing address
127 LINDSAY CT, ELYRIA, OH 44035-8857
(440) 213-3822
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RJ870797
OH
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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