Individual
EDWARD M KENSHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1629 OWEN DR, FAYETTEVILLE, NC 28304-3456
(910) 484-2284
(910) 484-1673
Mailing address
1726 METROMEDICAL DR, FAYETTEVILLE, NC 28304-3861
(910) 484-2284
(910) 484-1673
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1799
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89093JU
—
NC
Enumeration date
07/08/2006
Last updated
03/07/2023
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