Lakeville Spine & Health | |
20176 Heritage Dr, Lakeville, MN 55044-6855 | |
(952) 985-8808 | |
Not Available |
Full Name | Lakeville Spine & Health |
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Type | Facility |
Speciality | Chiropractor |
Location | 20176 Heritage Dr, Lakeville, 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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1043873821 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Kent Ellis Carder |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1902389687 PECOS PAC ID: 3870845910 Enrollment ID: I20181017003200 |
Provider Name | Valeriy Dmitrievich Telkov |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114403391 PECOS PAC ID: 6204170103 Enrollment ID: I20181204001429 |
Mailing Address | Practice Location Address |
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Lakeville Spine & Health 20176 Heritage Dr, Lakeville, MN 55044-6855 Ph: (952) 985-8808 | Lakeville Spine & Health 20176 Heritage Dr, Lakeville, MN 55044-6855 Ph: (952) 985-8808 |
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