Organization
RANDOLPH CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH J RANDOLPH CHIROPRACTOR DC (OWNER OF BUSINESS)
(205) 468-3464
Entity
Organization
Contact information
Practice address
7596 US HWY 43, GUIN, AL 35563
(205) 468-3464
(205) 468-3724
Mailing address
PO BOX 370, GUIN, AL 35563
(205) 468-3464
(205) 468-3724
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1931
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51003438
BCBS
—
Enumeration date
09/08/2006
Last updated
10/11/2007
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