| Doctor Name: | MR. KENNETH ELWOOD |
| NPI Number: | 1679743298 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, CMT |
| License Number: | 4704202174 |
| Business Practice Address: | 1673 W Millington Rd Fostoria, MI - 484359725 |
| Business Phone Number: | 9897952641 |
| Business Fax Number: | |
| Mailing Address: | 1673 W Millington Rd, FOSTORIA |
| State: | MI |
| Postal Code: | 484359725 |
| Phone Number: | 9897952641 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2008 |
| NPI Last Update Date: | 03/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0000X |
| License Number: | 4704202174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pain Management |
| Taxonomy Definition: | |