Provider Demographics
NPI:1669930301
Name:RODGERS, BETHANY MICHELLE (DC, LMT)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:MICHELLE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:DC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MORELAND TRL APT B
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9613
Mailing Address - Country:US
Mailing Address - Phone:585-500-0355
Mailing Address - Fax:
Practice Address - Street 1:1641 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1604
Practice Address - Country:US
Practice Address - Phone:585-473-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor