Individual
KENNON MARK LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E MAIN ST, ATTICA, IN 47918-1949
(765) 299-3259
Mailing address
2251 E 50 S, ATTICA, IN 47918-7834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014715A
IN
Other
Enumeration date
01/29/2024
Last updated
02/03/2024
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