Individual
MR. KENNETH LEE UNDERWOOD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3015 HIGHWAY 95, SUITE 105, BULLHEAD CITY, AZ 86442-4334
(928) 763-2001
(928) 763-2038
Mailing address
PO BOX 20828, BULLHEAD CITY, AZ 86439-0828
(928) 763-2001
(928) 763-2038
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1934
AZ
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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