| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1350 20th Ave Sw, Minot, North Dakota |
| Authorized Official Name and Position | Matthew Hanson (OWNER) |
| Authorized Official Contact | 7018522800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1350 20th Ave Sw Minot ND 58701-6452 Ph: (701) 852-2800 | 1350 20th Ave Sw Minot ND 58701 Ph: (701) 852-2800 |
| NPI Number | 1356599427 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 07/16/2018 |
| Medicare PECOS PAC ID | 7517034556 |
|---|---|
| Medicare Enrollment ID | O20080917000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356599427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 928 (North Dakota) | Primary |
| Provider Name | Matthew C Hanson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144450263 PECOS PAC ID: 7517007172 Enrollment ID: I20121228000471 |
| Provider Name | Crystal L Long |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1629310628 PECOS PAC ID: 1456640713 Enrollment ID: I20160510002088 |
| Provider Name | William Luke Fielhaber |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982794350 PECOS PAC ID: 5890040901 Enrollment ID: I20180613002203 |
Mckenzie County Healthcare Systems Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 18th Ave Se, Minot, ND 58701 Phone: 701-852-6143 Fax: 701-842-4025 | |
Minot State University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 University Ave W, Student Health Center, Minot, ND 58707 Phone: 701-858-3371 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3520 N Broadway, Minot, ND 58703 Phone: 877-522-1275 Fax: 509-491-3031 |