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Individual

MR. KEVIN MICHAEL POWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1903 SUNSET AVE, UTICA, NY 13502-5617
(315) 735-4496
Mailing address
1903 SUNSET AVE, UTICA, NY 13502-5617
(315) 735-4496

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
000184
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000184
LISCENSE
NY
Enumeration date
05/11/2011
Last updated
05/11/2011
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