Provider Demographics
NPI:1861565723
Name:NEALLY, ROCHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:
Last Name:NEALLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 E 4TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-8261
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3645 E 4TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90814-8261
Practice Address - Country:US
Practice Address - Phone:562-987-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor