Provider Demographics
NPI:1760430185
Name:NAGEL, RODNEY VANCE (DC)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:VANCE
Last Name:NAGEL
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 1:3985 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-1828
Mailing Address - Country:US
Mailing Address - Phone:989-771-2225
Mailing Address - Fax:989-754-2225
Practice Address - Street 1:3985 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-1828
Practice Address - Country:US
Practice Address - Phone:989-771-2225
Practice Address - Fax:989-754-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU30488Medicare UPIN