Provider Demographics
NPI:1821152513
Name:ROCK SPRINGS CHIROPRACTIC HEALTH CENTER P.C.
Entity Type:Organization
Organization Name:ROCK SPRINGS CHIROPRACTIC HEALTH CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:STEFFENSMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC CHIROPRACTOR
Authorized Official - Phone:307-382-3090
Mailing Address - Street 1:215 WINSTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901
Mailing Address - Country:US
Mailing Address - Phone:307-382-3090
Mailing Address - Fax:307-362-1024
Practice Address - Street 1:215 WINSTON DRIVE
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901
Practice Address - Country:US
Practice Address - Phone:307-382-3090
Practice Address - Fax:307-362-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1407758OtherUMWA
WYW302846Medicare PIN
WY1407758OtherUMWA