Provider Demographics
NPI:1669552576
Name:FROEHLE, ROSANN MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ROSANN
Middle Name:MARIE
Last Name:FROEHLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 SAINT CROIX TRL N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55043-9719
Mailing Address - Country:US
Mailing Address - Phone:651-436-6000
Mailing Address - Fax:651-436-7579
Practice Address - Street 1:76 SAINT CROIX TRL N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:MN
Practice Address - Zip Code:55043-9719
Practice Address - Country:US
Practice Address - Phone:651-436-6000
Practice Address - Fax:651-436-7579
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3036-012111N00000X
MN3158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38876500Medicaid
WI47058Medicare UPIN
WI70982Medicare ID - Type Unspecified