Provider Demographics
NPI:1891120341
Name:RHODES, JASON K (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:K
Last Name:RHODES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11710 OLD BALLAS RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7076
Mailing Address - Country:US
Mailing Address - Phone:314-983-9355
Mailing Address - Fax:314-991-0201
Practice Address - Street 1:11710 OLD BALLAS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7076
Practice Address - Country:US
Practice Address - Phone:314-983-9355
Practice Address - Fax:314-991-0201
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010034392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor