Provider Demographics
NPI:1902832223
Name:EILRICH, ROBERT JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:EILRICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 HWY 60 W,
Mailing Address - Street 2:SUITE #1
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021
Mailing Address - Country:US
Mailing Address - Phone:507-384-3800
Mailing Address - Fax:507-384-3803
Practice Address - Street 1:1620 HWY 60 W,
Practice Address - Street 2:SUITE #1
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021
Practice Address - Country:US
Practice Address - Phone:507-384-3800
Practice Address - Fax:507-384-3803
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor