Individual
KENNETH WOOD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1123 S EVERGREEN AVE, CHANUTE, KS 66720-2953
(620) 212-0446
Mailing address
1123 S EVERGREEN AVE, CHANUTE, KS 66720-2953
(620) 212-0446
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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