Individual
KANDICE ROETHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17275 WARWICK ST, DETROIT, MI 48219-4207
(313) 742-9887
Mailing address
17275 WARWICK ST, DETROIT, MI 48219-4207
(313) 742-9887
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
MI
Other
Enumeration date
08/07/2026
Last updated
08/07/2026
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