Waterbrook, Kenton Lee

Waterbrook, Kenton Lee is an individual health care provider with primary practice located at 3370 E Jolly Rd , Lansing MI 48910-8552. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Waterbrook, Kenton Lee can be contacted via phone (517) 487-3717.

Contact Information

Primary practice address
3370 E Jolly Rd Lansing MI 48910-8552
Fax: (517) 487-3472
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X KW008742 Michigan

Profile Details

NPI number 1750377966
LBN Legal business name Waterbrook, Kenton Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Aug 12th, 2011 - about 13 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 1750377966 NPPES
Michigan MEDICAID 1912972

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