Dr Austyn Dean Wasko, DC | |
1150 Montreal Ave Ste 105, Saint Paul, MN 55116-2393 | |
(218) 343-2606 | |
Not Available |
Full Name | Dr Austyn Dean Wasko |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 1150 Montreal Ave Ste 105, Saint Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750044616 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 6891 (Minnesota) | Primary |
Provider Name | Optimal Life Chiropractic Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1144853540 PECOS PAC ID: 7517394679 Enrollment ID: O20200302001324 |
Mailing Address | Practice Location Address |
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Dr Austyn Dean Wasko, DC 1150 Montreal Ave Ste 105, Saint Paul, MN 55116-2393 Ph: (218) 343-2606 | Dr Austyn Dean Wasko, DC 1150 Montreal Ave Ste 105, Saint Paul, MN 55116-2393 Ph: (218) 343-2606 |
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