Provider Demographics
NPI:1912225624
Name:RAK CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:RAK CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-208-4305
Mailing Address - Street 1:3169 WELLNER DR NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-7329
Mailing Address - Country:US
Mailing Address - Phone:507-208-4305
Mailing Address - Fax:
Practice Address - Street 1:3169 WELLNER DR NE
Practice Address - Street 2:SUITE C
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-7329
Practice Address - Country:US
Practice Address - Phone:507-208-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5370111N00000X
MN5369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty