Provider Demographics
NPI:1427690817
Name:ROLLE AND DEWITT CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:ROLLE AND DEWITT CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-449-2303
Mailing Address - Street 1:106 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1545
Mailing Address - Country:US
Mailing Address - Phone:517-543-7595
Mailing Address - Fax:
Practice Address - Street 1:106 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1545
Practice Address - Country:US
Practice Address - Phone:517-543-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service