Provider Demographics
NPI:1962765891
Name:RAHN CHIROPRACTIC & REHAB
Entity type:Organization
Organization Name:RAHN CHIROPRACTIC & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-229-1733
Mailing Address - Street 1:3636 N 1ST ST
Mailing Address - Street 2:105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6800
Mailing Address - Country:US
Mailing Address - Phone:559-229-1733
Mailing Address - Fax:559-229-1765
Practice Address - Street 1:3636 N 1ST ST
Practice Address - Street 2:105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6800
Practice Address - Country:US
Practice Address - Phone:559-229-1733
Practice Address - Fax:559-229-1765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19253Medicare Oscar/Certification