Provider Demographics
NPI:1043672843
Name:SEDLACEK, MICHAEL RODNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RODNEY
Last Name:SEDLACEK
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 1:745 COMMUNITY DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-6708
Mailing Address - Country:US
Mailing Address - Phone:319-530-7370
Mailing Address - Fax:
Practice Address - Street 1:745 COMMUNITY DR
Practice Address - Street 2:SUITE D
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-6708
Practice Address - Country:US
Practice Address - Phone:319-530-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor