Provider Demographics
NPI:1588028740
Name:CROSS-BORDER CHIROPRACTIC LIMITED LLC
Entity Type:Organization
Organization Name:CROSS-BORDER CHIROPRACTIC LIMITED LLC
Other - Org Name:RAUCH FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:RAUCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-355-0078
Mailing Address - Street 1:179 OWLS HEAD LN
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-5401
Mailing Address - Country:US
Mailing Address - Phone:802-253-1051
Mailing Address - Fax:
Practice Address - Street 1:394 MOUNTAIN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4678
Practice Address - Country:US
Practice Address - Phone:802-253-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006.0000677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty