Provider Demographics
NPI:1710342159
Name:ROWENHORST CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ROWENHORST CHIROPRACTIC LLC
Other - Org Name:ROWENHORST FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:ROWENHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-695-3307
Mailing Address - Street 1:77 ERIE VILLAGE SQ UNIT 150
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-6995
Mailing Address - Country:US
Mailing Address - Phone:918-695-3307
Mailing Address - Fax:
Practice Address - Street 1:77 ERIE VILLAGE SQ UNIT 150
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-6995
Practice Address - Country:US
Practice Address - Phone:918-695-3307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty