Individual
DR. MARK ROERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
52 33RD AVE S, SAINT CLOUD, MN 56301-3722
(320) 251-1080
Mailing address
32 32ND AVE S, SAINT CLOUD, MN 56301-6392
(320) 251-1080
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3259
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689215900
—
MN
Enumeration date
04/11/2007
Last updated
11/15/2017
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