MEDICARE: GERALD D RHODES DC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC001111L	PA

General Provider Information

NPI Number	:	1356341481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERALD D RHODES DC PC

Provider Business Mailing Address
First Line	:	411 BROAD ST
Second Line	:
City	:	MONTOURSVILLE
State	:	PA
Zip	:	17754-2315
Country	:	US
Telephone Number	:	570-368-2500
Fax Number	:	570-368-3639

Provider Business Practice Location Address
First Line	:	411 BROAD ST
Second Line	:
City	:	MONTOURSVILLE
State	:	PA
Zip	:	17754-2315
Country	:	US
Telephone Number	:	570-368-2500
Fax Number	:	570-368-3639

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERALD DUANE RHODES
Credential	:	DC
Telephone Number	:	570-368-2500

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	08/22/2020

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