St Raphaels Chiropractic Care Center Pllc | |
115 1st St W # 3, Milaca, MN 56353-1101 | |
(320) 362-7900 | |
(320) 362-7904 |
Full Name | St Raphaels Chiropractic Care Center Pllc |
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Type | Facility |
Speciality | Chiropractor |
Location | 115 1st St W # 3, Milaca, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740816941 | NPI | - | NPPES |
170123100 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
Provider Name | Kip A Smith |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1497854392 PECOS PAC ID: 2567365232 Enrollment ID: I20170526000053 |
Provider Name | Kip A Smith |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1497854392 PECOS PAC ID: 2567365232 Enrollment ID: I20190621001982 |
Mailing Address | Practice Location Address |
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St Raphaels Chiropractic Care Center Pllc 115 1st St W # 3, Milaca, MN 56353-1101 Ph: (320) 362-7900 | St Raphaels Chiropractic Care Center Pllc 115 1st St W # 3, Milaca, MN 56353-1101 Ph: (320) 362-7900 |
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