Provider Demographics
NPI:1538653167
Name:RHODES, BEAU JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:BEAU
Middle Name:JOSEPH
Last Name:RHODES
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 1:8499 OLD REDWOOD HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-8058
Mailing Address - Country:US
Mailing Address - Phone:707-838-8400
Mailing Address - Fax:
Practice Address - Street 1:8499 OLD REDWOOD HWY STE 204
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-8058
Practice Address - Country:US
Practice Address - Phone:408-218-3049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor