MEDICARE: ANDREW M RODGERS

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		NJ

General Provider Information

NPI Number	:	1457540494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW M RODGERS

Provider Business Mailing Address
First Line	:	530 MAIN ST
Second Line	:	SUITE 2
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4506
Country	:	US
Telephone Number	:	201-592-6200
Fax Number	:	201-592-6401

Provider Business Practice Location Address
First Line	:	530 MAIN ST
Second Line	:	SUITE 2
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4506
Country	:	US
Telephone Number	:	201-592-6200
Fax Number	:	201-592-6401

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDREW M RODGERS
Credential	:	DC
Telephone Number	:	201-592-6200

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	12/07/2007

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Directions to “ANDREW M RODGERS ” Practice Location

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