| Kenneth Koolwick, | |
|
15175 N Sheldon Rd, Plymouth, MI 48170-2483 | |
| (734) 207-1400 | |
| Not Available |
| Full Name | Kenneth Koolwick |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 15175 N Sheldon Rd, Plymouth, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396551008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | (NU) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Koolwick, 9545 Steephollow Dr, White Lake, MI 48386-2370 Ph: (248) 640-7369 | Kenneth Koolwick, 15175 N Sheldon Rd, Plymouth, MI 48170-2483 Ph: (734) 207-1400 |
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