Provider Demographics
NPI:1013416213
Name:BLAIR-RODGERS, SUZANNE PATRICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:PATRICIA
Last Name:BLAIR-RODGERS
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 1:245 S ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-2713
Mailing Address - Country:US
Mailing Address - Phone:719-574-6006
Mailing Address - Fax:
Practice Address - Street 1:245 S ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-2713
Practice Address - Country:US
Practice Address - Phone:719-574-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-03
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor