NPI 1154245553

Kandice Roetherford

Practitioner Driver Detroit, MI

Practice location

Address: 17275 Warwick St, Detroit, MI 48219-4207
Phone: (313) 742-9887

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1154245553
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Aug 2026
Record last updated: 7 Aug 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.