Healthcare Provider Details

I. General information

NPI: 1669715645
Provider Name (Legal Business Name): R.C. SPINE CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 WELLNER DR NE # 103
ROCHESTER MN
55906-4436
US

IV. Provider business mailing address

3160 WELLNER DR NE # 103
ROCHESTER MN
55906-4436
US

V. Phone/Fax

Practice location:
  • Phone: 507-206-4338
  • Fax: 507-206-3932
Mailing address:
  • Phone: 507-206-4338
  • Fax: 507-206-3932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number5637
License Number StateMN

VIII. Authorized Official

Name: DR. RYAN STEINER
Title or Position: CO-OWNER
Credential: D.C.
Phone: 507-206-4337