Provider Demographics
NPI:1376515056
Name:WERNER, RHONDA (DC)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:
Last Name:WERNER
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 1:822 CLEARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-9610
Mailing Address - Country:US
Mailing Address - Phone:704-421-2333
Mailing Address - Fax:
Practice Address - Street 1:1267 EBENEZER ROAD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732
Practice Address - Country:US
Practice Address - Phone:803-329-6361
Practice Address - Fax:803-329-0251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH486Medicaid
SCCH2955Medicaid
SCCH2955Medicaid
SCAA10438314Medicare ID - Type Unspecified