Kroll, Justin S

Kroll, Justin S is an sole proprietor health care provider with primary practice located at 1902 13Th St , Port Huron MI 48060-6238. He recently has only one registered license in Other Service Providers / Prevention Professional, which is considered as his primary health care specialty. Kroll, Justin S can be contacted via phone (810) 300-8536.

Contact Information

Primary practice address
1902 13Th St Port Huron MI 48060-6238
Phone: (810) 300-8536
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Prevention Professional 405300000X 1863 Connecticut

Profile Details

NPI number 1609410596
LBN Legal business name Kroll, Justin S
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2019
Last updated Dec 10th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609410596 NPPES
Connecticut MEDICAID 1863
Connecticut Other 0000000

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