Provider Demographics
NPI:1891231171
Name:RIVERSTONE CHIROPRACTIC AND WELLNESS PC
Entity Type:Organization
Organization Name:RIVERSTONE CHIROPRACTIC AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-454-6046
Mailing Address - Street 1:3764 MINNEHAHA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2668
Mailing Address - Country:US
Mailing Address - Phone:612-545-5815
Mailing Address - Fax:
Practice Address - Street 1:3764 MINNEHAHA AVE
Practice Address - Street 2:SUITEB
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406
Practice Address - Country:US
Practice Address - Phone:612-721-1518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty