Individual
MR. KENNETH MICHAEL YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16203 COURTHOUSE RD, DINWIDDIE, DINWIDDIE, VA 23841-3431
(804) 721-4176
Mailing address
16203 COURTHOUSE RD, DINWIDDIE, DINWIDDIE, VA 23841-3431
(804) 721-4176
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
2705-062531C
VA
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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