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NPI Code Detail

MEDICARE: DR. COREY BRAD RODNICK D.C.

MEDICARE:  DR. COREY BRAD RODNICK  D.C.
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
1111N00000XChiropractor2301004924MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CR004924OTHERMILICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3950E661120OTHERMIBLUE CROSS

General Provider Information

NPI Number : 1891808614
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COREY BRAD RODNICK D.C.
Provider Business Mailing Address
First Line : 4604 N SAGINAW RD
Second Line : SUITE A
City : MIDLAND
State : MI
Zip : 48640-2387
Country : US
Telephone Number : 989-832-7535
Fax Number : 989-832-1631
Provider Business Practice Location Address
First Line : 4604 N SAGINAW RD
Second Line : SUITE A
City : MIDLAND
State : MI
Zip : 48640-2387
Country : US
Telephone Number : 989-832-7535
Fax Number : 989-832-1631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 07/08/2007

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Directions to “ DR. COREY BRAD RODNICK D.C.” Practice Location

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