MEDICARE: ROCHESTER CLINIC PLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP1100X	Podiatric Clinic/Center
2	261QP2300X	Primary Care Clinic/Center
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1861675159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCHESTER CLINIC PLC

Provider Business Mailing Address
First Line	:	3070 WELLNER DR NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-8427
Country	:	US
Telephone Number	:	507-218-3095
Fax Number	:	507-218-3097

Provider Business Practice Location Address
First Line	:	3070 WELLNER DR NE
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55906-8427
Country	:	US
Telephone Number	:	507-218-3095
Fax Number	:	507-218-3097

Authorized Official
Title or Position	:	CHIEF MANAGER
Name	:	DR. JENGYU LAI
Credential	:	DPM
Telephone Number	:	507-218-3095

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	05/12/2011

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Directions to “ROCHESTER CLINIC PLC ” Practice Location

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