Provider Demographics
NPI:1164939617
Name:ROCKENMACHER CHIROPRACTIC
Entity Type:Organization
Organization Name:ROCKENMACHER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ROCKENMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-598-9609
Mailing Address - Street 1:4152 KATELLA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-6606
Mailing Address - Country:US
Mailing Address - Phone:562-598-9609
Mailing Address - Fax:562-799-1462
Practice Address - Street 1:4152 KATELLA AVE STE 102
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6606
Practice Address - Country:US
Practice Address - Phone:562-598-9609
Practice Address - Fax:562-799-1462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty