Provider Demographics
NPI:1164723599
Name:ROONEY, KAYLEEN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLEEN
Middle Name:MARIE
Last Name:ROONEY
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 1:1463 KINGSWOOD PONDS RD
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2878
Mailing Address - Country:US
Mailing Address - Phone:651-681-9466
Mailing Address - Fax:
Practice Address - Street 1:1463 KINGSWOOD PONDS RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2878
Practice Address - Country:US
Practice Address - Phone:651-681-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor