MEDICARE: DR. RODNEY C DAVIS DC

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	158871-1202	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710988548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY C DAVIS DC

Provider Business Mailing Address
First Line	:	2061 E 9400 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-3128
Country	:	US
Telephone Number	:	801-733-0550
Fax Number	:	801-733-0075

Provider Business Practice Location Address
First Line	:	2061 E 9400 S
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-3128
Country	:	US
Telephone Number	:	801-733-0550
Fax Number	:	801-733-0075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	10/12/2007

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Directions to “ DR. RODNEY C DAVIS DC” Practice Location

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