Provider Demographics
NPI:1831379387
Name:ROLNICK CHIROPRACTIC WELLNESS CENTRE, P.A.
Entity type:Organization
Organization Name:ROLNICK CHIROPRACTIC WELLNESS CENTRE, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-283-1168
Mailing Address - Street 1:413 ALFRED ST
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3742
Mailing Address - Country:US
Mailing Address - Phone:207-283-1168
Mailing Address - Fax:
Practice Address - Street 1:413 ALFRED ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-3742
Practice Address - Country:US
Practice Address - Phone:207-283-1168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RO MM9784OtherMEDICARE GROUP NUMBER