Provider Demographics
NPI:1700845138
Name:ROCK CHIROPRACTIC
Entity Type:Organization
Organization Name:ROCK CHIROPRACTIC
Other - Org Name:STANGE CHIROPRACTIC CLINIC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RAAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-737-6824
Mailing Address - Street 1:721 8TH STREET SE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-7451
Mailing Address - Country:US
Mailing Address - Phone:712-737-6824
Mailing Address - Fax:712-737-6426
Practice Address - Street 1:721 8TH ST SE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-7451
Practice Address - Country:US
Practice Address - Phone:712-737-6824
Practice Address - Fax:712-737-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0273631Medicaid
IA31143OtherWELLMARK BCBS IA
IAI7599Medicare ID - Type Unspecified