Individual
KENNETH LEROY KING SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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