Provider Demographics
NPI:1265581755
Name:RICE, JODI LYNN (DC)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:RICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYNN
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1808 PARK LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 N MILLS AVE STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5378
Practice Address - Country:US
Practice Address - Phone:321-946-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9300111N00000X
FLCH9300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor