Individual
MR. KENNETH EUGENE HARBISON-BLEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
432 WINDROSE WAY, CHULA VISTA, CA 91910-7442
(415) 702-5199
Mailing address
432 WINDROSE WAY, CHULA VISTA, CA 91910-7442
(415) 702-5199
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
151669
CA
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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