Provider Demographics
NPI:1649366915
Name:GASKELL, RODNEY J (DC)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:GASKELL
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 1:2609 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-5745
Mailing Address - Country:US
Mailing Address - Phone:712-255-7037
Mailing Address - Fax:712-255-1353
Practice Address - Street 1:2609 GORDON DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-5745
Practice Address - Country:US
Practice Address - Phone:712-255-7037
Practice Address - Fax:712-255-1353
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0161000Medicaid
IA0161000Medicaid
IA12001Medicare ID - Type Unspecified