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Organization
SOUTHWEST CHIROPRACTIC CLINIC OF WORTHINGTON, PA
Active
Organization
SOUTHWEST CHIROPRACTIC CLINIC OF WORTHINGTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB JOHN ROETHLER D.C. (PRESIDENT, CHIROPRACTOR)
(507) 376-9663
Entity
Organization
Contact information
Practice address
1301 DIAGONAL RD, WORTHINGTON, MN 56187-1114
(507) 376-9663
(507) 376-9663
Mailing address
1301 DIAGONAL RD, WORTHINGTON, MN 56187-1114
(507) 376-9663
(507) 376-9663
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4388
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072H0SO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
01/08/2007
Last updated
08/22/2020
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