Provider Demographics
NPI:1922295542
Name:RAPP CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:RAPP CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-423-2900
Mailing Address - Street 1:15170 CHIPPENDALE AVE W
Mailing Address - Street 2:STE 200
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-2769
Mailing Address - Country:US
Mailing Address - Phone:651-423-2900
Mailing Address - Fax:651-423-1330
Practice Address - Street 1:15170 CHIPPENDALE AVE W
Practice Address - Street 2:STE 200
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-2769
Practice Address - Country:US
Practice Address - Phone:651-423-2900
Practice Address - Fax:651-423-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2010-12-15
Deactivation Date:2008-11-14
Deactivation Code:
Reactivation Date:2009-02-04
Provider Licenses
StateLicense IDTaxonomies
MN1466111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC04208Medicare PIN