Healthcare Provider Details

I. General information

NPI: 1376720870
Provider Name (Legal Business Name): CARLY BENDEWALD ROHDE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CARLY OVERBY BENDEWALD DC

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US

IV. Provider business mailing address

30 N GOULD ST STE N
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-2022
  • Fax:
Mailing address:
  • Phone: 605-663-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0009124
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: