Healthcare Provider Details

I. General information

NPI: 1619898186
Provider Name (Legal Business Name): RODNEY WRICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 IMPALA TRCE
WENDELL NC
27591-4447
US

IV. Provider business mailing address

504 IMPALA TRCE
WENDELL NC
27591-4447
US

V. Phone/Fax

Practice location:
  • Phone: 919-889-3340
  • Fax:
Mailing address:
  • Phone: 919-889-3340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: