Provider Demographics
NPI:1235712514
Name:RODRIGUEZ, KIMBERLY (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:RODRIGUEZ
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 1:1401 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3337
Mailing Address - Country:US
Mailing Address - Phone:703-302-0958
Mailing Address - Fax:
Practice Address - Street 1:1401 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3337
Practice Address - Country:US
Practice Address - Phone:703-465-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557717111N00000X
GACHIR010446111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty