Provider Demographics
NPI:1013787688
Name:ROTUNA CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ROTUNA CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROTUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:657-500-8014
Mailing Address - Street 1:100 N STATE COLLEGE BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-4236
Mailing Address - Country:US
Mailing Address - Phone:657-500-8014
Mailing Address - Fax:
Practice Address - Street 1:100 N STATE COLLEGE BLVD STE J
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-4236
Practice Address - Country:US
Practice Address - Phone:657-500-8014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty