MEDICARE: MARK A KENDALL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301005033	MI

General Provider Information

NPI Number	:	1255319851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A KENDALL DC

Provider Business Mailing Address
First Line	:	1203 N COMMERCE RD
Second Line	:
City	:	COMMERCE
State	:	MI
Zip	:	48382-2610
Country	:	US
Telephone Number	:	248-363-1775
Fax Number	:	248-363-3110

Provider Business Practice Location Address
First Line	:	1203 N COMMERCE RD
Second Line	:	BAY POINTE CHIROPRACTIC
City	:	COMMERCE
State	:	MI
Zip	:	48382-2610
Country	:	US
Telephone Number	:	248-363-1775
Fax Number	:	248-363-3110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2007

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Directions to “ MARK A KENDALL DC” Practice Location

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