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Individual

MR. KENNETH JAMES WOLFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PCC

Contact information

Practice address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0002752
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0002752
OH
Enumeration date
11/24/2009
Last updated
11/24/2009
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