Crow Wing Chiropractic Pc

NPI 1154741288 - Chiropractor - 111N00000X

NPI Details
NPI 1154741288
Enumeration Date 04/16/2014
Last Updated 06/04/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JEDEDIAH JEDEDIAH
Position CHIROPRACTOR
Phone (218) 205-1908
Fax
Practice Location
15229 EDGEWOOD DR STE 125
BAXTER MN, 56401-6920, US
Phone (218) 205-1908
Fax
Business Location
15229 EDGEWOOD DR STE 125
BAXTER MN, 56425, US
Phone (218) 454-2840
Fax (218) 454-2841
Toxanomy
Taxonomy Code 111N00000X
License State Minnesota
License Number 5700
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According to our database, Crow Wing Chiropractic Pc NPI is 1154741288, taxonomy code is 111N00000X and license number is 5700, license state is located at Minnesota. Crow Wing Chiropractic Pc physically located at 15229 Edgewood Dr Ste 125, Baxter MN, 56401-6920. NPI Number 1033115704 has the healthcare provider type.

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1154741288 NPI number is provided on an as is basis without warranty of any kind. 1154741288 is maintained by the National Plan & Provider Enumeration System. The contents of Crow Wing Chiropractic Pc are for informational purposes only.