Roedocker, Travis J
Roedocker, Travis J is an individual health care provider with primary practice located at 1001 20Th Ave Sw , Minot ND 58701. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Roedocker, Travis J can be contacted via phone (701) 852-0158.Contact Information
Primary practice address
1001 20Th Ave Sw
Minot ND 58701
Phone: (701) 852-0158
Fax: (701) 852-5630
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 716 | North Dakota |
Profile Details
| NPI number | 1700811148 |
|---|---|
| LBN Legal business name | Roedocker, Travis J |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700811148 | NPPES |
| Other | 711180 | GROUP PROVIDER # | |
| Other | 10810 | GROUP PROVIDER # | |
| MEDICAID | 12206 | GROUP PROVIDER # |
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