Healthcare Provider Details

I. General information

NPI: 1992489231
Provider Name (Legal Business Name): MACKENZIE KERSEY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W ROOSEVELT AVE
FOLEY AL
36535-1955
US

IV. Provider business mailing address

205 W ROOSEVELT AVE
FOLEY AL
36535-1955
US

V. Phone/Fax

Practice location:
  • Phone: 251-979-7199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2810
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: