| Premier Physical Healthcare Pllc | |
|
115 W Howard St Hibbing MN 55746-1548 | |
| (218) 262-3315 | |
| (218) 263-9648 |
| Full Name | Premier Physical Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 115 W Howard St, Hibbing, Minnesota |
| Authorized Official Name and Position | John Ryan Michaels (OWNER) |
| Authorized Official Contact | 2182623315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Physical Healthcare Pllc 115 W Howard St Hibbing MN 55746-1548 Ph: (218) 262-3315 | Premier Physical Healthcare Pllc 115 W Howard St Hibbing MN 55746-1548 Ph: (218) 262-3315 |
| NPI Number | 1811267214 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 10/31/2012 |
| Medicare PECOS PAC ID | 0244493906 |
|---|---|
| Medicare Enrollment ID | O20120523000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811267214 | NPI | - | NPPES |
| 1811267214 | Other | MN | BLUE CROSS BLUE SHIELD MN |
| 1811267214 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 29671 (Minnesota) | Primary |
| Provider Name | Daniel S Vechell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275634628 PECOS PAC ID: 8426005414 Enrollment ID: I20050401000291 |
| Provider Name | Kristine E Michaels |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528326220 PECOS PAC ID: 2264697754 Enrollment ID: I20120709000181 |
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