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Individual

KENYA CASTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8249 MONROE AVE, MUNSTER, IN 46321-1605
(773) 875-3575
Mailing address
8249 MONROE AVE, MUNSTER, IN 46321-1605
(773) 875-3575

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
4670077184
IN

Other

Enumeration date
05/19/2023
Last updated
05/19/2023
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