Provider Demographics
NPI:1003049883
Name:BOIS, KAPEDJANIE (DC)
Entity type:Individual
Prefix:DR
First Name:KAPEDJANIE
Middle Name:
Last Name:BOIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WATERMAN ST
Mailing Address - Street 2:STE 1B
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3116
Mailing Address - Country:US
Mailing Address - Phone:401-415-9585
Mailing Address - Fax:401-415-9586
Practice Address - Street 1:154 WATERMAN ST
Practice Address - Street 2:STE 1B
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3116
Practice Address - Country:US
Practice Address - Phone:401-415-9585
Practice Address - Fax:401-415-9586
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00585111N00000X
CT1809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI002453301Medicare PIN