Individual
KERA TI VONDA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
129 KY 15 N, CAMPTON, KY 41301
(606) 668-7420
(606) 668-7404
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 436-5797
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/03/2010
Last updated
11/07/2011
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