Individual
JOHN KENO RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5392
Mailing address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5392
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4351050735
MI
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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