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General NPI Number Information
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NPI Number | 1063029718
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Entity Type | Organization
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Legal Business Name | ROTHROCK CHIROPRACTIC AND REHABILITATION LLC
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Dates
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Enumeration Date | 09/27/2020
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 1402 S ATHERTON ST STE 204
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City | STATE COLLEGE
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State | PA
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Zip | 16801-6255
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Country | US
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Telephone | 814-441-5532
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Fax | 814-556-2110
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Provider Business Mailing Address
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Address Line | 138 W WHITEHALL RD
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City | STATE COLLEGE
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State | PA
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Zip | 16801-5931
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Country | US
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Telephone | 586-255-9170
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Fax | 312-253-1419
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Authorized Official
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Title or Position | PRESIDENT, DOCTOR OF CHIROPRACTIC
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Name | DR. EMERY VAUGHN PITCEL
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Credential | DC
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Telephone | 586-255-9170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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