| Healthsource Of Prior Lake | |
|
6880 Boudin St Ne Ste 230, Prior Lake, MN 55372-1510 | |
| (952) 447-0985 | |
| (952) 447-0986 |
| Full Name | Healthsource Of Prior Lake |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 6880 Boudin St Ne Ste 230, Prior 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 |
|---|---|---|---|
| 1528457645 | NPI | - | NPPES |
| 350005214 | Other | MN | MEDICARE PTAN |
| 1043555055 | Other | MN | INDIVIDUAL PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 5713 (Minnesota) | Primary |
| Provider Name | Samantha M Hermsen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043555055 PECOS PAC ID: 7012162415 Enrollment ID: I20130311000494 |
| Provider Name | Brittany Christina Fussy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740941764 PECOS PAC ID: 4385036904 Enrollment ID: I20220111002112 |
| Provider Name | Marissa Roeske |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1508613217 PECOS PAC ID: 0042652463 Enrollment ID: I20240530000950 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Prior Lake 8791 Knollwood Dr, Eden Prairie, MN 55347-1719 Ph: (952) 447-0985 | Healthsource Of Prior Lake 6880 Boudin St Ne Ste 230, Prior Lake, MN 55372-1510 Ph: (952) 447-0985 |
Melissa Engelson, Dc, Pllc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 15815 Franklin Trl Se, Suite 500, Prior Lake, MN 55372 Phone: 952-567-1005 | |
Pivotal Family Chiropractic Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 16731 Highway 13 S Ste 107a, Prior Lake, MN 55372 Phone: 320-582-0582 | |
Connor Thomas Wears, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 6885 Boudin St Ne Ste 200, Prior Lake, MN 55372 Phone: 651-583-8971 Fax: 612-682-4897 | |
Deborah Genrick, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 14180 Commerce Ave Ne, Prior Lake, MN 55372 Phone: 952-447-3395 Fax: 953-447-3396 | |
Dr. Samantha Marie Davidson Hermsen, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 6880 Boudin St Ne Ste 230, Prior Lake, MN 55372 Phone: 952-447-0985 Fax: 952-447-0986 | |
Collins Chiropractic Pa Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 16670 Franklin Trl Se, Suite 120c, Prior Lake, MN 55372 Phone: 952-447-5770 Fax: 952-447-5780 | |
Michele Schueller Stapf, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 4124 Raspberry Ridge Rd Ne, Prior Lake, MN 55372 Phone: 952-240-0541 |