| |
307 Ivy Ave Se, Richmond, MN 56368 | |
(320) 597-8999 | |
(320) 597-8995 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 307 Ivy Ave Se, Richmond, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902862592 | NPI | - | NPPES |
647220600 | Other | MEDICAL ASSISTANCE | |
31G09SP | Other | BLUE CROSS BLUE SHIELD GR | |
350049912 | Other | RAILROAD MEDICARE | |
411508205 | Other | AETNA & SIGNA PREFERRED O | |
1016069 | Other | HEALTH SERVICE MANAGEMENT | |
31G09SP | Other | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 003166 (Minnesota) | Primary |
Provider Name | Jennifer A Lourey |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1134261597 PECOS PAC ID: 9931113727 Enrollment ID: I20060201000034 |
Mailing Address | Practice Location Address |
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307 Ivy Ave Se, Richmond, MN 56368 Ph: (320) 597-8999 | 307 Ivy Ave Se, Richmond, MN 56368 Ph: (320) 597-8999 |
Corey Douglas Norton, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 307 Ivy Ave Se, Richmond, MN 56368 Phone: 320-597-8999 Fax: 320-597-8995 |