Provider Demographics
NPI:1831261585
Name:RODGERS, WENDI L (DC)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:L
Last Name:RODGERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:L
Other - Last Name:POLHEMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:21 BROADWAY
Mailing Address - Street 2:HANDS ON FAMILY CHIROPRACTIC DR WENDI POLHEMUS DC STE E
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677
Mailing Address - Country:US
Mailing Address - Phone:201-505-0001
Mailing Address - Fax:201-505-4844
Practice Address - Street 1:21 BROADWAY
Practice Address - Street 2:SUITE E
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677
Practice Address - Country:US
Practice Address - Phone:201-505-0001
Practice Address - Fax:201-505-4844
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00498100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
022068Medicare ID - Type Unspecified