Provider Demographics
NPI:1639739659
Name:RODGERS, CASSIE (DC)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:RODGERS
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 1:7300 NEW LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4812
Mailing Address - Country:US
Mailing Address - Phone:502-326-9950
Mailing Address - Fax:502-326-9952
Practice Address - Street 1:7300 NEW LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4812
Practice Address - Country:US
Practice Address - Phone:502-326-9950
Practice Address - Fax:502-326-9952
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor