Individual
KENNY ROOSEVELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N/A
Contact information
Practice address
1380 HOWARD ST FL 2, SAN FRANCISCO, CA 94103-2649
(628) 754-9216
Mailing address
1380 HOWARD ST FL 2, SAN FRANCISCO, CA 94103-2649
(628) 754-9216
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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