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1020 Marie Avenue, South St. Paul, MN 55075 | |
(651) 455-5463 | |
(651) 455-9720 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 1020 Marie Avenue, South St. Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1548314792 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 4267 (Minnesota) | Primary |
Provider Name | Virginia A Rivas-castro |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1649455338 PECOS PAC ID: 2961585807 Enrollment ID: I20080214000591 |
Mailing Address | Practice Location Address |
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1020 Marie Avenue, South St Paul, MN 55075 Ph: (651) 455-5463 | 1020 Marie Avenue, South St. Paul, MN 55075 Ph: (651) 455-5463 |