| Spine And Sport Chiropractic | |
|
700 Western Ave Suite 200 Minot ND 58701-3760 | |
| (701) 838-2121 | |
| Not Available |
| Full Name | Spine And Sport Chiropractic |
|---|---|
| Speciality | Clinic/Center |
| Location | 700 Western Ave, Minot, North Dakota |
| Authorized Official Name and Position | Andrea Burckhard (OWNER/CHIROPRACTOR) |
| Authorized Official Contact | 7018382121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spine And Sport Chiropractic 700 Western Ave Suite 200 Minot ND 58701-3760 Ph: (701) 838-2121 | Spine And Sport Chiropractic 700 Western Ave Suite 200 Minot ND 58701-3760 Ph: (701) 838-2121 |
| NPI Number | 1154709111 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 05/11/2015 |
| Medicare PECOS PAC ID | 4981918398 |
|---|---|
| Medicare Enrollment ID | O20150729009191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154709111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1003 (North Dakota) | Primary |
| Provider Name | Andrea Burckhard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1538486154 PECOS PAC ID: 1557499704 Enrollment ID: I20100507000509 |
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