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General NPI Number Information
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NPI Number | 1861495707
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Entity Type | Individual
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Provider Name | JEREMY D RODROCK DC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 603 AMES ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-5200
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Country | US
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Telephone | 785-594-4894
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Fax | 785-594-2597
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Provider Business Mailing Address
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Address Line | 603 AMES ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-5200
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Country | US
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Telephone | 785-594-4894
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Fax | 785-594-2597
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 01-04705
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License Number State | KS
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