Provider Demographics
NPI:1043613540
Name:NORTHLAND CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:NORTHLAND CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:ROHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-848-0291
Mailing Address - Street 1:1476 130TH AVE
Mailing Address - Street 2:
Mailing Address - City:WELCOME
Mailing Address - State:MN
Mailing Address - Zip Code:56181-1314
Mailing Address - Country:US
Mailing Address - Phone:507-848-0323
Mailing Address - Fax:
Practice Address - Street 1:1476 130TH AVE
Practice Address - Street 2:
Practice Address - City:WELCOME
Practice Address - State:MN
Practice Address - Zip Code:56181-1314
Practice Address - Country:US
Practice Address - Phone:507-848-0323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350004440Medicare PIN