| Northern Chiropractic And Wellness Center Llc | |
|
730 Apollo Dr Suite 120 Lino Lakes MN 55014-3037 | |
| (651) 797-3756 | |
| Not Available |
| Full Name | Northern Chiropractic And Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 730 Apollo Dr, Lino Lakes, Minnesota |
| Authorized Official Name and Position | Tyler Paul Hanson (OWNER) |
| Authorized Official Contact | 6517973756 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Chiropractic And Wellness Center Llc 730 Apollo Dr Suite 120 Lino Lakes MN 55014-3037 Ph: (651) 797-3756 | Northern Chiropractic And Wellness Center Llc 730 Apollo Dr Suite 120 Lino Lakes MN 55014-3037 Ph: (651) 797-3756 |
| NPI Number | 1134678410 |
|---|---|
| Provider Enumeration Date | 09/27/2016 |
| Last Update Date | 12/15/2016 |
| Medicare PECOS PAC ID | 7618257668 |
|---|---|
| Medicare Enrollment ID | O20161208000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134678410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 6001 (Minnesota) | Primary |
| Provider Name | Justin Dw Nye |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962689901 PECOS PAC ID: 3072707074 Enrollment ID: I20101103001309 |
| Provider Name | Tyler P Hanson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386034650 PECOS PAC ID: 9739493578 Enrollment ID: I20150806011270 |
Fairview Clinics-lino Lakes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7455 Village Dr, Lino Lakes, MN 55014 Phone: 651-717-3400 Fax: 651-717-3499 | |
Health Path Chiropractic And Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6776 Lake Dr, Suite 210, Lino Lakes, MN 55014 Phone: 651-528-8260 |