Provider Demographics
NPI:1912081365
Name:STAEHELI, ROBERT JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:STAEHELI
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 1:1484 CLARMAR LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1608
Mailing Address - Country:US
Mailing Address - Phone:612-840-2517
Mailing Address - Fax:651-330-0826
Practice Address - Street 1:1484 CLARMAR LN
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55113-1608
Practice Address - Country:US
Practice Address - Phone:612-840-2517
Practice Address - Fax:651-330-0826
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU32375Medicare UPIN
MN350001009Medicare ID - Type Unspecified