Healthcare Provider Details

I. General information

NPI: 1821207101
Provider Name (Legal Business Name): JOSPHINE KANDIE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOSPHINE ROTICH

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2834 BESSEMER RD
BIRMINGHAM AL
35208-3630
US

IV. Provider business mailing address

PO BOX 39527
BIRMINGHAM AL
35208-0079
US

V. Phone/Fax

Practice location:
  • Phone: 205-788-7246
  • Fax:
Mailing address:
  • Phone: 205-788-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2058
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: