| Organization Name: | KENNETH A BORENITSCH D O P C |
| NPI Number: | 1407120165 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH ALBERT BORENITSCH (PRESIDENT) |
| Mailing Address: | 1237 E Parkdale Ave Suite 2 Manistee |
| State: | MI US |
| Postal Code: | 496609353 |
| Phone Number: | 2317238521 |
| Fax Number: | 2313980478 |
| NPI Enumeration Date: | 02/28/2012 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101007441 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |