| |
1025 Selby Ave, Suite 101, Saint Paul, MN 55104-6533 | |
(651) 228-9000 | |
(651) 224-2806 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 1025 Selby Ave, Saint Paul, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801961826 | NPI | - | NPPES |
3C122MC | Other | MN | BC/BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 5356 (Minnesota) | Secondary |
111N00000X | Chiropractor | 5367 (Minnesota) | Secondary |
261Q00000X | Clinic/center | 3005 (Minnesota) | Primary |
Mailing Address | Practice Location Address |
---|---|
1025 Selby Ave, Ste 101, Saint Paul, MN 55104-6533 Ph: (651) 228-9000 | 1025 Selby Ave, Suite 101, Saint Paul, MN 55104-6533 Ph: (651) 228-9000 |