| Crosstown Chiropractic Pa | |
|
2330 Crosstown Blvd Ne Ham Lake MN 55304-4471 | |
| (763) 434-5714 | |
| Not Available |
| Full Name | Crosstown Chiropractic Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 2330 Crosstown Blvd Ne, Ham Lake, Minnesota |
| Authorized Official Name and Position | Mackenzie Engelstad (CEO) |
| Authorized Official Contact | 5073829026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crosstown Chiropractic Pa 2330 Crosstown Blvd Ne Ste A Ham Lake MN 55304-4471 Ph: (507) 382-9026 | Crosstown Chiropractic Pa 2330 Crosstown Blvd Ne Ham Lake MN 55304-4471 Ph: (763) 434-5714 |
| NPI Number | 1083350664 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 06/28/2022 |
| Medicare PECOS PAC ID | 0446638381 |
|---|---|
| Medicare Enrollment ID | O20220603002145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083350664 | NPI | - | NPPES |
| H100853627 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mackenzie Engelstad |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1720749781 PECOS PAC ID: 9537551726 Enrollment ID: I20220120001449 |
| Provider Name | Logan Engelstad |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760121594 PECOS PAC ID: 2264811405 Enrollment ID: I20220620000496 |
A. Cardinal Counseling, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3045 159th Ave Ne, Ham Lake, MN 55304 Phone: 612-444-2982 |