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General NPI Number Information
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NPI Number | 1831303023
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Entity Type | Organization
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Legal Business Name | KERRY RODOCKER
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1233 N WEBB RD SUITE 100
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City | GRAND ISLAND
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State | NE
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Zip | 68803-3321
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Country | US
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Telephone | 308-398-2255
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Fax | 308-398-2256
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Provider Business Mailing Address
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Address Line | 1233 N WEBB RD SUITE 100
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City | GRAND ISLAND
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State | NE
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Zip | 68803-3321
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Country | US
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Telephone | 308-398-2255
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Fax | 308-398-2256
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Authorized Official
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Title or Position | OWNER
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Name | DR. KERRY ANN RODOCKER
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Credential | D.C.
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Telephone | 308-398-2255
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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 | 1338
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License Number State | NE
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