Provider Demographics
NPI:1992444285
Name:ROLC LLC
Entity type:Organization
Organization Name:ROLC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-910-0712
Mailing Address - Street 1:7133 S 76TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9736
Mailing Address - Country:US
Mailing Address - Phone:414-858-1212
Mailing Address - Fax:
Practice Address - Street 1:7133 S 76TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9736
Practice Address - Country:US
Practice Address - Phone:414-858-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty