| Minnetonka Family Chiropractic Llc | |
|
11349 Highway 7 Minnetonka MN 55305-5300 | |
| (952) 229-8750 | |
| Not Available |
| Full Name | Minnetonka Family Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11349 Highway 7, Minnetonka, Minnesota |
| Authorized Official Name and Position | Peter Jon Gianforte (OWNER) |
| Authorized Official Contact | 9523220323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnetonka Family Chiropractic Llc 11349 Highway 7 Minnetonka MN 55305-5300 Ph: (952) 229-8750 | Minnetonka Family Chiropractic Llc 11349 Highway 7 Minnetonka MN 55305-5300 Ph: (952) 229-8750 |
| NPI Number | 1023398138 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 09/10/2011 |
| Medicare PECOS PAC ID | 8224209358 |
|---|---|
| Medicare Enrollment ID | O20110922000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023398138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Minnesota) | Primary |
| Provider Name | Peter J Gianforte |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962782060 PECOS PAC ID: 0941471072 Enrollment ID: I20110922000186 |
| Provider Name | Colin Schulze |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1003219825 PECOS PAC ID: 7618290321 Enrollment ID: I20150105002145 |
| Provider Name | Justin Thomas Lee |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134627698 PECOS PAC ID: 2365703972 Enrollment ID: I20180222001380 |
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