Black, Kenneth

Black, Kenneth is an individual health care provider with primary practice located at 86Th 22Nd Ave Memorial Home, Moundridge KS 67107-7003. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Black, Kenneth can be contacted via phone (620) 345-2901.

Contact Information

Primary practice address
86Th 22Nd Ave Memorial Home Moundridge KS 67107-7003
Phone: (620) 345-2901
Fax: (620) 345-2937
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 14-01477 Kansas

Profile Details

NPI number 1073719050
LBN Legal business name Black, Kenneth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers