Provider Demographics
NPI:1174883151
Name:ROCHESTER CHIROPRACTIC AND WELLNESS, PLLC
Entity type:Organization
Organization Name:ROCHESTER CHIROPRACTIC AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPLITTSTOESSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-248-4418
Mailing Address - Street 1:2711 COMMERCE DR NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2262
Mailing Address - Country:US
Mailing Address - Phone:507-206-4660
Mailing Address - Fax:
Practice Address - Street 1:2711 COMMERCE DR NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2262
Practice Address - Country:US
Practice Address - Phone:507-206-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5670111N00000X
MN5666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty