| Advanced Wellness & Sports Rehab Pa | |
|
11132 Commerce Ln N, Champlin, MN 55316-3112 | |
| (763) 291-0202 | |
| Not Available |
| Full Name | Advanced Wellness & Sports Rehab Pa |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Sports Physician |
| Location | 11132 Commerce Ln N, Champlin, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790181915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NS0005X | Chiropractor - Sports Physician | 5614 (Minnesota) | Primary |
| Provider Name | Diane Katherine Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760755953 PECOS PAC ID: 5890959068 Enrollment ID: I20120620000125 |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Wellness & Sports Rehab Pa 11132 Commerce Ln N, Champlin, MN 55316-3112 Ph: (763) 291-0202 | Advanced Wellness & Sports Rehab Pa 11132 Commerce Ln N, Champlin, MN 55316-3112 Ph: (763) 291-0202 |
Achieve Health Clinic Of Chiropractic Chiropractor Medicare: Medicare Enrolled Practice Location: 11350 Aquila Dr N Ste 825, Champlin, MN 55316 Phone: 763-323-3456 | |
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