Individual
KENNETH DAVID DIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
15 BERGERON WAY, STOUGHTON, MA 02072-1392
(508) 631-8222
Mailing address
15 BERGERON WAY, STOUGHTON, MA 02072-1392
(508) 631-8222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN85377
MA
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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