Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI Number | 1043089147 |
| LBN Legal business name | KENT MEDICAL |
| Authorized official | WILEY KENT - (PHYSICIAN ASSISTANT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 12/29/2023 |
| Last updated | 06/05/2024 - More than a year ago |
| Identifiers | n/a |
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KENT MEDICAL
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