Provider Demographics
NPI:1669848040
Name:ROJO VENTURES, INC.
Entity Type:Organization
Organization Name:ROJO VENTURES, INC.
Other - Org Name:LIFE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROJO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-752-5555
Mailing Address - Street 1:1372 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5701
Mailing Address - Country:US
Mailing Address - Phone:406-752-5555
Mailing Address - Fax:
Practice Address - Street 1:1372 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5701
Practice Address - Country:US
Practice Address - Phone:406-752-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-3572305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service