| Premier Health Of Roseville, Ltd | |
|
1601 Larpenteur Ave, St Paul, MN 55113 | |
| (651) 487-2198 | |
| (651) 646-0283 |
| Full Name | Premier Health Of Roseville, Ltd |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1601 Larpenteur Ave, 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 |
|---|---|---|---|
| 1770792400 | NPI | - | NPPES |
| 761153600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Eric G Koehler |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1710002175 PECOS PAC ID: 1658447446 Enrollment ID: I20120202000764 |
| Provider Name | Alison M Weaver |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275069676 PECOS PAC ID: 6800154709 Enrollment ID: I20180212000591 |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health Of Roseville, Ltd 1601 Larpenteur Ave, St Paul, MN 55113 Ph: (651) 487-2198 | Premier Health Of Roseville, Ltd 1601 Larpenteur Ave, St Paul, MN 55113 Ph: (651) 487-2198 |
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