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Individual

MRS. INGRID ROSE JOHNSON RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
851 OLD WINSTON RD SUITE 105, PIEDMONT CHIROPRACTIC CENTER, KERNERSVILLE, NC 27284
(336) 993-9690
(336) 993-9692
Mailing address
PO BOX 19364, GREENSBORO, NC 27419
(336) 392-2633
(336) 856-7296

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2778
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2024753
1ST HEALTH NETWORK
NC
01
645599
AEN UHC
NC
05
890845A
NC
01
9156656
PHCS
NC
Enumeration date
11/16/2006
Last updated
07/08/2007
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