Individual
ROBERT MARTIN KENNUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
329 PORTER AVE, D'YOUVILLE COLLEGE, BUFFALO, NY 14201
(716) 829-8309
Mailing address
4805 TRANSIT RD APT 2903, DEPEW, NY 14043-4911
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001014-1
NY
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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