Provider Demographics
NPI:1063029718
Name:ROTHROCK CHIROPRACTIC AND REHABILITATION LLC
Entity Type:Organization
Organization Name:ROTHROCK CHIROPRACTIC AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:EMERY
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:PITCEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-255-9170
Mailing Address - Street 1:138 W WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5931
Mailing Address - Country:US
Mailing Address - Phone:586-255-9170
Mailing Address - Fax:312-253-1419
Practice Address - Street 1:1402 S ATHERTON ST STE 204
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6255
Practice Address - Country:US
Practice Address - Phone:814-441-5532
Practice Address - Fax:814-556-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-27
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty