Individual
KENNETH LYNN HUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1059 N 100 W, BEAVER, UT 84713-1690
(435) 438-7280
(435) 438-7210
Mailing address
PO BOX 1690, BEAVER, UT 84713-1690
(435) 438-7280
(435) 438-7210
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3434871206
UT
Other
Enumeration date
06/16/2005
Last updated
07/08/2007
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