Provider Demographics
NPI:1366740045
Name:TONY RHODES DC
Entity type:Organization
Organization Name:TONY RHODES DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-567-3456
Mailing Address - Street 1:15495 SW SEQUOIA PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-6117
Mailing Address - Country:US
Mailing Address - Phone:503-567-3456
Mailing Address - Fax:503-726-1152
Practice Address - Street 1:15495 SW SEQUOIA PKWY STE 150
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-6117
Practice Address - Country:US
Practice Address - Phone:503-567-3456
Practice Address - Fax:503-726-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4007111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty