Provider Demographics
NPI:1598885220
Name:ADDLEMAN, KENT HERBERT (LAC)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:HERBERT
Last Name:ADDLEMAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-4276
Mailing Address - Country:US
Mailing Address - Phone:319-277-6036
Mailing Address - Fax:
Practice Address - Street 1:124 E 18TH ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-4276
Practice Address - Country:US
Practice Address - Phone:319-277-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-28171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist