Provider Demographics
NPI:1982978730
Name:RHOADES, BENJAMIN FORREST (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:FORREST
Last Name:RHOADES
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 1:16735 CRANLYN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-1822
Mailing Address - Country:US
Mailing Address - Phone:704-892-5252
Mailing Address - Fax:888-503-7522
Practice Address - Street 1:16735 CRANLYN RD
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-1822
Practice Address - Country:US
Practice Address - Phone:704-892-5252
Practice Address - Fax:888-503-7522
Is Sole Proprietor?:No
Enumeration Date:2012-02-25
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919833Medicaid
NC5919833Medicaid