Individual
MR. KENNETH R LYTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 MORRIS RD SE, LOS LUNAS, NM 87031-5242
(505) 866-2300
(505) 866-2309
Mailing address
750 MORRIS RD, LOS LUNAS, NM 87031-5242
(505) 866-2300
(505) 866-2309
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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