Individual
DR. KENNETH WAYNE VAN WYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
911 WASHINGTON ST, PELLA, IA 50219-1503
(641) 628-3511
Mailing address
911 WASHINGTON ST, PELLA, IA 50219-1503
(641) 628-3511
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
02863
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014472
—
IA
01
—
01447
BLUE SHIELD
IA
05
—
1014472
—
IA
01
—
47928
BLUE SHIELD
IA
Enumeration date
02/06/2007
Last updated
07/08/2007
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