MEDICARE: KENNETH KEHS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1811656382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH KEHS

Provider Business Mailing Address
First Line	:	2450 OAK HILL CIR APT 1011
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-9590
Country	:	US
Telephone Number	:	682-688-4288
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 OAK HILL CIR APT 1011
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-9590
Country	:	US
Telephone Number	:	682-688-4288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	12/13/2021

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Directions to “ KENNETH KEHS ” Practice Location

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