Provider Demographics
NPI:1548711401
Name:ROLING CHIROPRACTIC, LLC.
Entity type:Organization
Organization Name:ROLING CHIROPRACTIC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:660-833-4662
Mailing Address - Street 1:2041 COUNTY ROAD 2080
Mailing Address - Street 2:
Mailing Address - City:ARMSTRONG
Mailing Address - State:MO
Mailing Address - Zip Code:65230-2036
Mailing Address - Country:US
Mailing Address - Phone:660-676-9487
Mailing Address - Fax:
Practice Address - Street 1:630 N MORLEY ST STE 103A
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-2556
Practice Address - Country:US
Practice Address - Phone:660-833-4662
Practice Address - Fax:660-833-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016030787111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty