Provider Demographics
NPI:1174746382
Name:CHITTOCK, RORIE BETH (DC)
Entity type:Individual
Prefix:DR
First Name:RORIE
Middle Name:BETH
Last Name:CHITTOCK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RORIE
Other - Middle Name:BETH
Other - Last Name:BAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:603 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3917
Mailing Address - Country:US
Mailing Address - Phone:530-257-4890
Mailing Address - Fax:
Practice Address - Street 1:603 NORTH ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3917
Practice Address - Country:US
Practice Address - Phone:530-257-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor