KENNETH TISDALE, L.C.I.C.I., LMT #548
Contractor
Active
Individual
NPI: 1962709956
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Contractor | 171W00000X | Yes | LMT # 5488 (NM) |
Frequently Asked Questions
NPI 1962709956 is the National Provider Identifier for KENNETH TISDALE, L.C.I.C.I., LMT #548, a Contractor provider located in Albuquerque, NM. This NPI was enumerated on February 28, 2011.
KENNETH TISDALE, L.C.I.C.I., LMT #548 practices at 201 EUBANK BLVD NE, B1, Albuquerque, NM 87123.
Quick Facts
- NPI
- 1962709956
- Type
- Individual
- Enumerated
- Feb 28, 2011
- Last Updated
- Feb 28, 2011
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