Provider Demographics
NPI:1518938968
Name:UNDERWOOD, RHONDA LEIGH (DC)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:LEIGH
Last Name:UNDERWOOD
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 1:321 SOUTH DIXIE STREET
Mailing Address - Street 2:
Mailing Address - City:HORSE CAVE
Mailing Address - State:KY
Mailing Address - Zip Code:42749-1240
Mailing Address - Country:US
Mailing Address - Phone:270-786-2225
Mailing Address - Fax:270-786-3690
Practice Address - Street 1:321 S DIXIE ST
Practice Address - Street 2:
Practice Address - City:HORSE CAVE
Practice Address - State:KY
Practice Address - Zip Code:42749-1248
Practice Address - Country:US
Practice Address - Phone:270-786-2225
Practice Address - Fax:270-786-3690
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000305831OtherANTHEM
000000305831OtherANTHEM
U97865Medicare UPIN
4780Medicare ID - Type Unspecified