Healthcare Provider Details

I. General information

NPI: 1518899178
Provider Name (Legal Business Name): KENYDEE CYNTHIA ROOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 E MARKET ST STE B
NAPPANEE IN
46550-9396
US

IV. Provider business mailing address

109 W FELICITY ST
ANGOLA IN
46703-2108
US

V. Phone/Fax

Practice location:
  • Phone: 574-773-2220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08003605A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: