| Collyard Chiropractic P A | |
|
510 Freeport Ave Nw Ste F Elk River MN 55330-3007 | |
| (763) 274-0377 | |
| (763) 633-0366 |
| Full Name | Collyard Chiropractic P A |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 Freeport Ave Nw Ste F, Elk River, Minnesota |
| Authorized Official Name and Position | Carrie Lynn Collyard-glinsek (OWNER) |
| Authorized Official Contact | 7632740377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Collyard Chiropractic P A 510 Freeport Ave Nw Ste F Elk River MN 55330-3007 Ph: (763) 274-0377 | Collyard Chiropractic P A 510 Freeport Ave Nw Ste F Elk River MN 55330-3007 Ph: (763) 274-0377 |
| NPI Number | 1972837649 |
|---|---|
| Provider Enumeration Date | 09/28/2009 |
| Last Update Date | 01/07/2015 |
| Medicare PECOS PAC ID | 7618015520 |
|---|---|
| Medicare Enrollment ID | O20091113000453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972837649 | NPI | - | NPPES |
| 966407600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC 4090 (Minnesota) | Primary |
| Provider Name | Carrie L Collyard-glinsek |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205894870 PECOS PAC ID: 9133139348 Enrollment ID: I20060503000203 |
| Provider Name | Erick Thompson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477071066 PECOS PAC ID: 3375955719 Enrollment ID: I20201209001352 |
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