Provider Demographics
NPI:1043554702
Name:HORGEN, RODNEY C (DC)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:C
Last Name:HORGEN
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 1:37958 AMEN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DEER RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:56636-3064
Mailing Address - Country:US
Mailing Address - Phone:218-301-4402
Mailing Address - Fax:
Practice Address - Street 1:37958 AMEN LAKE RD
Practice Address - Street 2:
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636-3064
Practice Address - Country:US
Practice Address - Phone:218-301-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor