NPI 1023818192
Kenyahdal Gatewood, PRC
Practice location
- Address
- 1044 W Bristol Rd, Flint, MI 48507-5516
- Phone
- (810) 238-0483
- Mailing address
- 1116 W Bristol Rd, Flint, MI 48507-5518
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1023818192
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 17 Mar 2025
- Record last updated
- 17 Mar 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.