Individual
BENJAMIN KIENENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2864 S NETTLETON AVE, SPRINGFIELD, MO 65807-5970
(417) 605-7100
Mailing address
2864 S NETTLETON AVE, SPRINGFIELD, MO 65807-5970
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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