Individual
KENIA GINETTE GANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 BLACKHORSE HILL RD, COATESVILLE, PA 19320-2040
(610) 384-7711
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601005037
MI
363A00000X
Physician Assistant
PA04736
TX
363AM0700X
Medical Physician Assistant
5601005037
MI
363AM0700X
Medical Physician Assistant
Primary
MA054255
PA
Other
Enumeration date
09/26/2006
Last updated
02/06/2018
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