Provider Demographics
NPI:1700017613
Name:GENTLE ROLFING, LLC
Entity Type:Organization
Organization Name:GENTLE ROLFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ROLFER STRUCTURAL INTEGRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:POVOLNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-660-0146
Mailing Address - Street 1:1884 CANDELA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5647
Mailing Address - Country:US
Mailing Address - Phone:505-660-0146
Mailing Address - Fax:
Practice Address - Street 1:1884 CANDELA ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5647
Practice Address - Country:US
Practice Address - Phone:505-660-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty