Provider Demographics
NPI:1801947098
Name:RHODES, NANCY LEE (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:RHODES
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 1:5455 US HIGHWAY 522 N
Mailing Address - Street 2:
Mailing Address - City:MC CLURE
Mailing Address - State:PA
Mailing Address - Zip Code:17841-9126
Mailing Address - Country:US
Mailing Address - Phone:717-543-6238
Mailing Address - Fax:
Practice Address - Street 1:5455 US HIGHWAY 522 N
Practice Address - Street 2:
Practice Address - City:MC CLURE
Practice Address - State:PA
Practice Address - Zip Code:17841-9126
Practice Address - Country:US
Practice Address - Phone:717-543-6238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003044-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188035OtherHIGHMARK BLUE SHIELD #
PA01705601OtherASH INDIVIDUAL #
PA02642500OtherASH GROUP #
PA02642500OtherASH GROUP #