Birch Lake Chiropractic Clinic, Llc | |
4635 White Bear Pkwy, White Bear Lake, MN 55110-3300 | |
(651) 429-5329 | |
(651) 429-2759 |
Full Name | Birch Lake Chiropractic Clinic, Llc |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 4635 White Bear Pkwy, White Bear Lake, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255407136 | NPI | - | NPPES |
273GOBI | Other | BCBS - CLINIC # | |
231600 | Other | ACN | |
6763511-00 | Other | MHCP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 751 (Minnesota) | Primary |
Provider Name | Grant A Erickson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1932275815 PECOS PAC ID: 4688560063 Enrollment ID: I20040224000034 |
Mailing Address | Practice Location Address |
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Birch Lake Chiropractic Clinic, Llc 4635 White Bear Pkwy, White Bear Lake, MN 55110-3300 Ph: (651) 429-5329 | Birch Lake Chiropractic Clinic, Llc 4635 White Bear Pkwy, White Bear Lake, MN 55110-3300 Ph: (651) 429-5329 |
Healthsource Of White Bear Lake, Pllc Chiropractor Medicare: Medicare Enrolled Practice Location: 4801 Highway 61 N, 105, White Bear Lake, MN 55110 Phone: 651-762-5433 Fax: 651-762-7504 | |
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