| Shanna C Miller, Dc Pllc | |
|
11417 Hanson Blvd Nw St 101 Coon Rapids MN 55433-3993 | |
| (763) 754-1482 | |
| (763) 754-6116 |
| Full Name | Shanna C Miller, Dc Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11417 Hanson Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Shanna Colleen Miller (OWNER/ CHIROPRACTOR) |
| Authorized Official Contact | 7637541482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shanna C Miller, Dc Pllc 11417 Hanson Blvd Nw Coon Rapids MN 55433-3992 Ph: (763) 754-1482 | Shanna C Miller, Dc Pllc 11417 Hanson Blvd Nw St 101 Coon Rapids MN 55433-3993 Ph: (763) 754-1482 |
| NPI Number | 1982979100 |
|---|---|
| Provider Enumeration Date | 03/21/2012 |
| Last Update Date | 04/19/2017 |
| Medicare PECOS PAC ID | 7315109204 |
|---|---|
| Medicare Enrollment ID | O20120511000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982979100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5585 (Minnesota) | Primary |
| Provider Name | Shanna C Miller |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1720356355 PECOS PAC ID: 0941203939 Enrollment ID: I20120511000040 |
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