Individual
NATHAN GORDON KENISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
252 ELLIOTT ST, BEVERLY, MA 01915-2419
(978) 578-8323
Mailing address
21 HERRICK ST APT 1, BEVERLY, MA 01915-3125
(978) 578-8323
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8979
MA
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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