Healthcare Provider Details

I. General information

NPI: 1548455371
Provider Name (Legal Business Name): RIMROCK CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 PATTERSON RD STE 3
GRAND JUNCTION CO
81506-8848
US

IV. Provider business mailing address

316 HIGHWAY 6 AND 50 STE B
FRUITA CO
81521-2642
US

V. Phone/Fax

Practice location:
  • Phone: 970-201-3567
  • Fax:
Mailing address:
  • Phone: 970-858-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5535
License Number StateCO

VIII. Authorized Official

Name: GREG HAITZ
Title or Position: PRESIDENT
Credential: DC
Phone: 970-201-3567