Individual
KENNETH W PADGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2374 MOUND RD RTE 414, WATERLOO, NY 13165
(315) 539-3262
(315) 539-5221
Mailing address
PO BOX 664, WATERLOO, NY 13165
(315) 539-3262
(315) 539-5221
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0002701
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50057
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/07/2006
Last updated
12/11/2007
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