| Grand Health Chiropractic And Wellness Center | |
|
1025 Selby Ave Suite 101 Saint Paul MN 55104-6533 | |
| (651) 228-9000 | |
| (651) 224-2806 |
| Full Name | Grand Health Chiropractic And Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1025 Selby Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Trisha Lee Augustine (MANAGING MEMBER) |
| Authorized Official Contact | 9522202857 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Health Chiropractic And Wellness Center 1025 Selby Ave Suite 101 Saint Paul MN 55104-6533 Ph: (651) 228-9000 | Grand Health Chiropractic And Wellness Center 1025 Selby Ave Suite 101 Saint Paul MN 55104-6533 Ph: (651) 228-9000 |
| NPI Number | 1912304627 |
|---|---|
| Provider Enumeration Date | 11/24/2014 |
| Last Update Date | 04/27/2015 |
| Medicare PECOS PAC ID | 0547583189 |
|---|---|
| Medicare Enrollment ID | O20150106001577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912304627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5983 (Minnesota) | Primary |
| Provider Name | Trisha Lee Augustine |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1447656178 PECOS PAC ID: 1456674092 Enrollment ID: I20150128001426 |
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