Individual
KENNETH JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
806 W MAPLE ST, FARMINGTON, NM 87401-5631
(505) 327-7105
Mailing address
1907 HOLLYHOCK CIR, FARMINGTON, NM 87401-2439
(505) 710-0946
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0580
NM
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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