Healthcare Provider Details

I. General information

NPI: 1720157415
Provider Name (Legal Business Name): ROSALIND LORENA CANHAM D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 N 7TH ST
PHOENIX AZ
85006-2102
US

IV. Provider business mailing address

2041 N 7TH ST
PHOENIX AZ
85006-2102
US

V. Phone/Fax

Practice location:
  • Phone: 602-255-0600
  • Fax: 602-255-0601
Mailing address:
  • Phone: 602-255-0600
  • Fax: 602-255-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number6019
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number2315
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: