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Individual

MR. KENT L JENEMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
1414 W FAIR AVE, SUITE 133, MARQUETTE, MI 49855-2675
(906) 225-3902
(906) 226-2661
Mailing address
1414 W FAIR AVENUE, SUITE 133, MARQUETTE, MI 49855
(906) 225-3902
(906) 226-2661

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302024574
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302024574
PHARMACIST LICENSE
MI
Enumeration date
09/04/2009
Last updated
09/04/2009
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