Healthcare Provider Details
I. General information
NPI: 1104980101
Provider Name (Legal Business Name): KENNETH BOYD STRICKLAND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4935 CENTURY ST NW SUITE 1
HUNTSVILLE AL
35816-1901
US
IV. Provider business mailing address
4935 CENTURY ST NW SUITE 1
HUNTSVILLE AL
35816-1901
US
V. Phone/Fax
- Phone: 256-830-4637
- Fax: 256-830-4638
- Phone: 256-830-4637
- Fax: 256-830-4638
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 1067 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: