Provider Demographics
NPI:1801134127
Name:RHODES, JOSHUA D (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:RHODES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 YEAGER AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-5558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3960 VALLEY GATEWAY BLVD
Practice Address - Street 2:SUITE A-1
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-6858
Practice Address - Country:US
Practice Address - Phone:540-520-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor