Individual
MR. KENNETH DANIEL RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DTR
Contact information
Practice address
1141 N MONROE DR, XENIA, OH 45385-1619
(937) 352-2374
Mailing address
1141 N MONROE DR, XENIA, OH 45385-1619
(937) 352-2374
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
00974451
—
Other
Enumeration date
01/18/2008
Last updated
01/18/2008
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