Provider Demographics
NPI:1063834562
Name:TOTAL FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:TOTAL FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RATH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-653-2190
Mailing Address - Street 1:1245 GUN CLUB RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-3379
Mailing Address - Country:US
Mailing Address - Phone:651-653-2190
Mailing Address - Fax:
Practice Address - Street 1:1245 GUN CLUB RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3379
Practice Address - Country:US
Practice Address - Phone:651-653-2190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5876261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center