Individual
DR. KENNETH GERARD WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1276A JUNGERMANN RD, SAINT PETERS, MO 63376-6961
(314) 707-5575
(636) 794-3012
Mailing address
4627 TAUNEYBROOK DR, SAINT LOUIS, MO 63128-2219
(314) 707-5575
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009874
IL
111N00000X
Chiropractor
2006003308
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038009874
—
IL
Enumeration date
08/21/2006
Last updated
03/25/2011
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