Provider Demographics
NPI:1023642352
Name:ROLING, JONATHAN LEE I (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:LEE
Last Name:ROLING
Suffix:I
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 1:11818 W 135TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-9399
Mailing Address - Country:US
Mailing Address - Phone:913-912-7007
Mailing Address - Fax:
Practice Address - Street 1:11818 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-9399
Practice Address - Country:US
Practice Address - Phone:913-921-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor