Wynne, Kevin G

Wynne, Kevin G is an sole proprietor health care provider with primary practice located at 365 Waymont Ct Suite 101, Lake Mary FL 32746-3552. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wynne, Kevin G can be contacted via phone (407) 321-9191.

Contact Information

Primary practice address
365 Waymont Ct Suite 101 Lake Mary FL 32746-3552
Phone: (407) 321-9191
Fax: (407) 321-9899
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CH7382 Florida

Profile Details

NPI number 1710970686
LBN Legal business name Wynne, Kevin G
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 25th, 2005
Last updated Oct 7th, 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 1710970686 NPPES
Florida Other 55683 BCBS
Florida MEDICAID 381358400 BCBS

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