East Valley Chiropractic | |
14050 Pilot Knob Rd Apple Valley MN 55124-6647 | |
(952) 423-5050 | |
(952) 423-4650 |
Full Name | East Valley Chiropractic |
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Speciality | Clinic/Center |
Location | 14050 Pilot Knob Rd, Apple Valley, Minnesota |
Authorized Official Name and Position | Kyle Martin Heffernan (CHIROPRACTOR) |
Authorized Official Contact | 5152930026 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East Valley Chiropractic 14050 Pilot Knob Rd Apple Valley MN 55124-6647 Ph: (952) 423-5050 | East Valley Chiropractic 14050 Pilot Knob Rd Apple Valley MN 55124-6647 Ph: (952) 423-5050 |
NPI Number | 1598165862 |
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Provider Enumeration Date | 08/24/2014 |
Last Update Date | 08/24/2014 |
Medicare PECOS PAC ID | 8426279571 |
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Medicare Enrollment ID | O20141015000881 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598165862 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 5970 (Minnesota) | Primary |
Provider Name | Ty J Hall |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1205215910 PECOS PAC ID: 3577879667 Enrollment ID: I20150903002700 |
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