Provider Demographics
NPI:1114003829
Name:ROSANN M. FROEHLE DC LLC
Entity Type:Organization
Organization Name:ROSANN M. FROEHLE DC LLC
Other - Org Name:LAKELAND FAMILY CHIROPRACTIC AND ACUPUNCT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-436-6000
Mailing Address - Street 1:76 SAINT CROIX TRL N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55043-9719
Mailing Address - Country:US
Mailing Address - Phone:651-436-6000
Mailing Address - Fax:651-436-7579
Practice Address - Street 1:76 SAINT CROIX TRL N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:MN
Practice Address - Zip Code:55043-9719
Practice Address - Country:US
Practice Address - Phone:651-436-6000
Practice Address - Fax:651-436-7579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN267850100Medicaid
MN3158OtherMN STATE LICENSE
WI38876500Medicaid
WI3036-012OtherWI STATE LICENSE
WI47058Medicare UPIN
WI000070982Medicare PIN