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1215387428 NPI number — ROCK CITY WELLNESS, LLC

NPI Number: 1215387428
Health Care Provider/Practitioner: ROCK CITY WELLNESS, LLC

Information about “1215387428” NPI (ROCK CITY WELLNESS, LLC) exists in 1215387428 in HTML format HTML  |  1215387428 in plain Text format TXT  |  1215387428 in PDF (Portable Document Format) PDF  |  1215387428 in an XML format XML  formats.

NPI Number : 1215387428 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215387428",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ROCK CITY WELLNESS, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5302 YACHT HAVEN GRANDE",
    "SecondLineMailingAddress": "UNIT 49",
    "MailingAddressCityName": "ST THOMAS",
    "MailingAddressStateName": "VI",
    "MailingAddressPostalCode": "00802-5004",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "340-998-7357",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5302 YACHT HAVEN GRANDE",
    "SecondLinePracticeLocationAddress": "SUITE 100",
    "PracticeLocationAddressCityName": "ST THOMAS",
    "PracticeLocationAddressStateName": "VI",
    "PracticeLocationAddressPostalCode": "00802-5004",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "340-998-7357",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/18/2016",
    "LastUpdateDate": "08/18/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ARVIDSON",
    "AuthorizedOfficialFirstName": "TYGUE",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "PARTNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.C.",
    "AuthorizedOfficialTelephoneNumber": "517-215-2243",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "72",
          "LicenseNumberStateCode": "VI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "68",
          "LicenseNumberStateCode": "VI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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