Individual
MR. KENNETH WAYNE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
528 CASS ST, LA CROSSE, WI 54601-4507
(608) 784-9922
(608) 784-2212
Mailing address
N753 E HILLS RD, LA CROSSE, WI 54601-2275
(608) 784-9922
(608) 784-2212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11324040
WI
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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