MEDICARE: TWIN CITIES MOBILE CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568123750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN CITIES MOBILE CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	727 COTTAGE AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-1708
Country	:	US
Telephone Number	:	612-226-8974
Fax Number	:

Provider Business Practice Location Address
First Line	:	727 COTTAGE AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-1708
Country	:	US
Telephone Number	:	612-226-8974
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAMANTHA ROTHBAUER
Credential	:	DC
Telephone Number	:	612-226-8974

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

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