Provider Demographics
NPI:1417024365
Name:RARDIN, JOSHUA AMYAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:AMYAS
Last Name:RARDIN
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 1:112 NE HAYES ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:50849-1048
Mailing Address - Country:US
Mailing Address - Phone:641-743-2756
Mailing Address - Fax:641-343-7308
Practice Address - Street 1:112 NE HAYES ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IA
Practice Address - Zip Code:50849-1048
Practice Address - Country:US
Practice Address - Phone:641-743-2756
Practice Address - Fax:641-343-7308
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06922111N00000X
IL038011345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor