Provider Demographics
NPI:1144732876
Name:SAUNDERS, KENNETH LEE
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:LEE
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 BORRIS CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-6443
Mailing Address - Country:US
Mailing Address - Phone:804-306-5533
Mailing Address - Fax:
Practice Address - Street 1:16400 STEDHAM CIR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1547
Practice Address - Country:US
Practice Address - Phone:703-675-8646
Practice Address - Fax:703-675-8646
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver