Provider Demographics
NPI:1811395379
Name:GLOVER, ROSHUN DEMONZ (DC)
Entity type:Individual
Prefix:DR
First Name:ROSHUN
Middle Name:DEMONZ
Last Name:GLOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 FORD PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5286
Mailing Address - Country:US
Mailing Address - Phone:205-519-4024
Mailing Address - Fax:
Practice Address - Street 1:5031 FORD PKWY STE 112
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5286
Practice Address - Country:US
Practice Address - Phone:205-519-4024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor