Individual
KENNETH CARL WIENCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
715 S HEALTH PKWY, MEDICAL OFFICE BUILDING 3, THREE RIVERS, MI 49093-8352
(269) 273-8471
(269) 273-9680
Mailing address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 273-9789
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101015914
MI
Other
Enumeration date
11/16/2005
Last updated
07/19/2011
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