Provider Demographics
NPI:1750488300
Name:HOLLINGER SR., RODNEY TRENT (DC)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:TRENT
Last Name:HOLLINGER SR.
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 1:1403 S HYDRAULIC ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-3616
Mailing Address - Country:US
Mailing Address - Phone:316-263-4171
Mailing Address - Fax:
Practice Address - Street 1:1403 S HYDRAULIC ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-3616
Practice Address - Country:US
Practice Address - Phone:316-263-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7121Medicare UPIN
KS007121Medicare ID - Type UnspecifiedMEDICARE