Provider Demographics
NPI:1497723910
Name:WEST, RODNEY ANDRE (DC)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:ANDRE
Last Name:WEST
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 1:921 COMMERCIAL ST NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4512
Mailing Address - Country:US
Mailing Address - Phone:770-679-5987
Mailing Address - Fax:770-679-0792
Practice Address - Street 1:921 COMMERCIAL ST NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4512
Practice Address - Country:US
Practice Address - Phone:770-679-5987
Practice Address - Fax:770-679-0792
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8958111N00000X
GACHIRO08495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor