| Chiropractors Of St. Anthony / Northeast | |
|
4833 Minnetonka Blvd, St Louis Park, MN 55416-2214 | |
| () - | |
| Not Available |
| Full Name | Chiropractors Of St. Anthony / Northeast |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 4833 Minnetonka Blvd, St Louis Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285812412 | NPI | - | NPPES |
| 787250000 | Medicaid | MN | |
| 1065328 | Other | MN | BCBS CLINIC ID |
| 119H8CH | Other | MN | BCBS MN ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4370 (Minnesota) | Primary |
| Provider Name | Scott D Salita |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265576003 PECOS PAC ID: 3678581550 Enrollment ID: I20060404000544 |
| Mailing Address | Practice Location Address |
|---|---|
| Chiropractors Of St. Anthony / Northeast 3813 Plymouth Rd, Minnetonka, MN 55305-5001 Ph: (612) 991-3139 | Chiropractors Of St. Anthony / Northeast 4833 Minnetonka Blvd, St Louis Park, MN 55416-2214 Ph: () - |
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