Provider Demographics
NPI:1417102385
Name:RHOADS, MARJORIE MARIE (DC RN)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:MARIE
Last Name:RHOADS
Suffix:
Gender:F
Credentials:DC RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-1839
Mailing Address - Country:US
Mailing Address - Phone:816-632-4405
Mailing Address - Fax:816-632-4406
Practice Address - Street 1:409 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1839
Practice Address - Country:US
Practice Address - Phone:816-632-4405
Practice Address - Fax:816-632-4406
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001305111N00000X
MO2002019484163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse