Provider Demographics
NPI:1447211875
Name:ROUGIER-MAAS, ROCHELLE L (DC)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:L
Last Name:ROUGIER-MAAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:L
Other - Last Name:ROUGIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-5000
Mailing Address - Fax:
Practice Address - Street 1:7500 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-3400
Practice Address - Country:US
Practice Address - Phone:612-835-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC3793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN782670200Medicaid
U76774Medicare UPIN
MN350004795Medicare PIN