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General NPI Number Information
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NPI Number | 1699609669
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Entity Type | Individual
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Provider Name | JOHN RODDICK DC
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Gender | Male
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | W164N11271 SQUIRE DR STE P2-200
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City | GERMANTOWN
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State | WI
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Zip | 53022-6018
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Country | US
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Telephone | 608-487-0489
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Fax |
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Provider Business Mailing Address
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Address Line | N170W21840 ROSEWOOD LN UNIT 1
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City | JACKSON
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State | WI
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Zip | 53037-9825
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Country | US
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Telephone | 608-487-0489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6352-12
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License Number State | WI
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