Provider Demographics
NPI:1962593095
Name:FOREST CITY CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:FOREST CITY CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:828-245-8962
Mailing Address - Street 1:190 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-2108
Mailing Address - Country:US
Mailing Address - Phone:828-245-8962
Mailing Address - Fax:828-245-4423
Practice Address - Street 1:467 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2920
Practice Address - Country:US
Practice Address - Phone:828-245-8962
Practice Address - Fax:828-245-4423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5914819Medicaid
NC5914819Medicaid