William C. Gustafson, D.c., P.a. | |
199 Coon Rapids Blvd, Suite 315, Coon Rapids, MN 55433-5861 | |
(763) 717-9510 | |
(763) 717-2988 |
Full Name | William C. Gustafson, D.c., P.a. |
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Type | Facility |
Speciality | Chiropractor |
Location | 199 Coon Rapids Blvd, Coon Rapids, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548497340 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2782 (Minnesota) | Primary |
Provider Name | William C Gustafson |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1760449664 PECOS PAC ID: 0244389054 Enrollment ID: I20090528000179 |
Mailing Address | Practice Location Address |
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William C. Gustafson, D.c., P.a. 199 Coon Rapids Blvd, Suite 315, Coon Rapids, MN 55433-5861 Ph: (763) 717-9510 | William C. Gustafson, D.c., P.a. 199 Coon Rapids Blvd, Suite 315, Coon Rapids, MN 55433-5861 Ph: (763) 717-9510 |
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