Provider Demographics
NPI:1578078861
Name:RODRIGUEZ, JANNETTE (DC)
Entity Type:Individual
Prefix:MRS
First Name:JANNETTE
Middle Name:
Last Name:RODRIGUEZ
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 1:19109 W CATAWBA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5612
Mailing Address - Country:US
Mailing Address - Phone:704-997-8694
Mailing Address - Fax:
Practice Address - Street 1:19109 W CATAWBA AVE STE 106
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5612
Practice Address - Country:US
Practice Address - Phone:704-997-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor