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General NPI Number Information
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NPI Number | 1992444285
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Entity Type | Organization
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Legal Business Name | ROLC LLC
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 7133 S 76TH ST
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City | FRANKLIN
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State | WI
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Zip | 53132-9736
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Country | US
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Telephone | 414-858-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 7133 S 76TH ST
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City | FRANKLIN
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State | WI
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Zip | 53132-9736
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Country | US
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Telephone | 414-858-1212
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. NICHOLAS LEE HERBERT
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Credential | DC
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Telephone | 815-910-0712
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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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