| Complete Chiropractic And Wellness, Pa | |
|
6640 Lyndale Ave S Ste 120 Richfield MN 55423-2385 | |
| (612) 866-1859 | |
| Not Available |
| Full Name | Complete Chiropractic And Wellness, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 6640 Lyndale Ave S Ste 120, Richfield, Minnesota |
| Authorized Official Name and Position | Nicholas Mellum (OWNER) |
| Authorized Official Contact | 6128661859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Chiropractic And Wellness, Pa 6640 Lyndale Ave S Ste 120 Richfield MN 55423-2385 Ph: (612) 866-1859 | Complete Chiropractic And Wellness, Pa 6640 Lyndale Ave S Ste 120 Richfield MN 55423-2385 Ph: (612) 866-1859 |
| NPI Number | 1033325220 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8224125901 |
|---|---|
| Medicare Enrollment ID | O20071026000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033325220 | NPI | - | NPPES |
| 088L3AS | Other | MN | BCBS |
| 101645 | Other | MN | HEALTHPARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4364 (Minnesota) | Primary |
| Provider Name | Nicholas A Mellum |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1831102870 PECOS PAC ID: 1850326836 Enrollment ID: I20050928000831 |
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