Individual
DR. KANDICE JOETTE WOMMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
142 VINE ST, BENTON, KY 42025-7472
(270) 527-0000
(270) 527-2121
Mailing address
142 VINE ST, BENTON, KY 42025-7472
(270) 527-0000
(270) 527-2121
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4556
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000077520
ANTHRM BCBS
KY
01
—
350052669
RAILROAD MEDICARE
KY
01
—
44-00390
UHC
KY
01
—
614099
ACN
KY
01
—
7670104
AETNA
KY
Enumeration date
07/07/2006
Last updated
10/16/2017
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