MEDICARE: DR. MARK KENDALL, D.C., P.C.

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	:	1538334412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MARK KENDALL, D.C., P.C.

Provider Business Mailing Address
First Line	:	9555 COMMERCE RD STE 1
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4165
Country	:	US
Telephone Number	:	248-363-1775
Fax Number	:	248-363-1776

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

Authorized Official
Title or Position	:	C.E.O.
Name	:	DR. MARK A. KENDALL
Credential	:	D.C.
Telephone Number	:	248-363-1775

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	10/31/2017

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