Provider Demographics
NPI:1386785525
Name:ROLOFF, ROBERT STEPHEN (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:ROLOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 65TH STREET EAST
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076
Mailing Address - Country:US
Mailing Address - Phone:654-451-1012
Mailing Address - Fax:651-453-1543
Practice Address - Street 1:2940 65TH STREET EAST
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076
Practice Address - Country:US
Practice Address - Phone:654-451-1012
Practice Address - Fax:651-453-1543
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0015914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN59869INOtherBLUE CROSS
MN94265OtherMEDICA
MN3707978Medicaid
MN230730OtherCHIRO CARE
MN411508205OtherHEALTH SERVICE MANAGEMENT
MN471727900OtherMN CARE
MN411508205OtherHEALTH SERVICE MANAGEMENT
MN350611060Medicare ID - Type Unspecified