Provider Demographics
NPI:1922016542
Name:ROHLFSEN, BRETT J (DC)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:J
Last Name:ROHLFSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S 50TH ST
Mailing Address - Street 2:STE 1120
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-6993
Mailing Address - Country:US
Mailing Address - Phone:515-222-1689
Mailing Address - Fax:515-222-0162
Practice Address - Street 1:640 S 50TH ST
Practice Address - Street 2:STE 1120
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-6993
Practice Address - Country:US
Practice Address - Phone:515-222-1689
Practice Address - Fax:515-222-0162
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA59827Medicare PIN