Provider Demographics
NPI:1649493776
Name:ROULUND CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:ROULUND CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROULUND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-222-5362
Mailing Address - Street 1:9584 N LARKSPUR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4620
Mailing Address - Country:US
Mailing Address - Phone:559-298-4524
Mailing Address - Fax:559-222-5028
Practice Address - Street 1:5150 N 6TH ST
Practice Address - Street 2:SUITE #100
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7510
Practice Address - Country:US
Practice Address - Phone:559-222-5362
Practice Address - Fax:559-222-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty