Individual
KENNETH LAURENCE GROLEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 BLANDING BLVD., ORANGE PARK, FL 32073
(904) 276-4611
Mailing address
225 BLANDING BLVD., KENS UNITED OPTICAL, ORANGE PARK, FL 32073
(904) 276-4611
(904) 276-4328
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D03062
FL
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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