Healthcare Provider Details

I. General information

NPI: 1790702660
Provider Name (Legal Business Name): KS MARKETING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 BENSTEIN RD STE 106
COMMERCE TOWNSHIP MI
48390-2912
US

IV. Provider business mailing address

4210 MARCELLO DR
COMMERCE TWP MI
48382-1661
US

V. Phone/Fax

Practice location:
  • Phone: 248-960-9895
  • Fax:
Mailing address:
  • Phone: 248-960-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL H UTLEY
Title or Position: OWNER
Credential:
Phone: 248-960-9895