Dr Jaime Roderick, DC | |
34730 Plymouth Rd, Livonia, MI 48150-1440 | |
(734) 680-8661 | |
Not Available |
Full Name | Dr Jaime Roderick |
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Gender | Female |
Speciality | Chiropractor |
Location | 34730 Plymouth Rd, Livonia, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144091448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2301401475 (Michigan) | Primary |
Provider Name | Pure Chiropractic Clinic Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1508280751 PECOS PAC ID: 7719118512 Enrollment ID: O20140319002192 |
Mailing Address | Practice Location Address |
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Dr Jaime Roderick, DC 34730 Plymouth Rd, Livonia, MI 48150-1440 Ph: (734) 680-8661 | Dr Jaime Roderick, DC 34730 Plymouth Rd, Livonia, MI 48150-1440 Ph: (734) 680-8661 |
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