Individual
CARTER KENNY MCGOWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 SUZIE LN, ATTICA, IN 47918-2009
(765) 762-6789
Mailing address
2920 E 700 N, PINE VILLAGE, IN 47975-8033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10003913A
IN
Other
Enumeration date
11/17/2018
Last updated
08/08/2024
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