Provider Demographics
NPI:1205046216
Name:RHODES, DANIEL A (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:RHODES
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 1:61239 TETHEROW DR STE 208
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3734
Mailing Address - Country:US
Mailing Address - Phone:650-515-5596
Mailing Address - Fax:
Practice Address - Street 1:61239 TETHEROW DR STE 208
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3734
Practice Address - Country:US
Practice Address - Phone:650-515-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0264770Medicare ID - Type Unspecified