| Organization Name: | KENDALL P. TABOR, D.P.M |
| NPI Number: | 1053597914 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENDALL P TABOR (OWNER/PODIATRIST) |
| Mailing Address: | 1414 W Fair Ave Ste 215 Marquette |
| State: | MI US |
| Postal Code: | 498552675 |
| Phone Number: | 9062257709 |
| Fax Number: | 9062257707 |
| NPI Enumeration Date: | 01/10/2008 |
| NPI Last Update Date: | 12/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 5901001089 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |