Individual
ODIANOSEN KELVIN UNEMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 RIDGE DR APT 2, MARION, IA 52302-3046
(832) 677-7406
Mailing address
210 RIDGE DR APT 2, MARION, IA 52302-3046
(832) 677-7406
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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