Individual
DR. KENNETH DALE WARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
28252 FORD RD, GARDEN CITY, MI 48135-2927
(734) 421-4110
Mailing address
28252 FORD RD, GARDEN CITY, MI 48135-2927
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7553
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4310208
—
MI
01
—
KW007553
LICENSE
MI
Enumeration date
07/25/2006
Last updated
07/08/2007
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