Individual
MR. KENNETH JAMES FLORENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 661-6260
(309) 662-1628
Mailing address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 661-6260
(309) 662-1628
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057-000930
IL
Other
Enumeration date
09/12/2025
Last updated
09/12/2025
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