Individual
KENNY D KWACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32979 COASTAL HWY, BETHANY BEACH, DE 19930-3752
(302) 537-3700
Mailing address
32979 COASTAL HWY, BETHANY BEACH, DE 19930-3752
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24597
MD
183500000X
Pharmacist
A1-0005020
DE
Other
Enumeration date
10/27/2016
Last updated
12/06/2016
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