Provider Demographics
NPI:1588150049
Name:OUT AND ABOUT CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:OUT AND ABOUT CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STAEHELI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-840-2517
Mailing Address - Street 1:1484 CLARMAR AVE W
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1608
Mailing Address - Country:US
Mailing Address - Phone:612-331-9999
Mailing Address - Fax:651-330-0826
Practice Address - Street 1:1484 CLARMAR AVE W
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1608
Practice Address - Country:US
Practice Address - Phone:612-331-9999
Practice Address - Fax:651-330-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty