Provider Demographics
NPI:1033846001
Name:100 CHIRO RODGERS LEX, PLLC
Entity Type:Organization
Organization Name:100 CHIRO RODGERS LEX, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:
Authorized Official - First Name:DR SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR-RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-617-8690
Mailing Address - Street 1:161 LEXINGTON GREEN CIR STE B15
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3379
Mailing Address - Country:US
Mailing Address - Phone:719-217-0895
Mailing Address - Fax:
Practice Address - Street 1:161 LEXINGTON GREEN CIR STE B15
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3379
Practice Address - Country:US
Practice Address - Phone:719-217-0895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty