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700 Western Ave Suite 200 Minot ND 58701-3760 | |
(701) 838-2121 | |
Not Available |
Full Name | |
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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 |
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700 Western Ave Suite 200 Minot ND 58701-3760 Ph: (701) 838-2121 | 700 Western Ave Suite 200 Minot ND 58701-3760 Ph: (701) 838-2121 |
NPI Number | 1154709111 |
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Provider Enumeration Date | 05/11/2015 |
Last Update Date | 05/11/2015 |
Medicare PECOS PAC ID | 4981918398 |
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Medicare Enrollment ID | O20150729009191 |
Identifier | Type | State | Issuer |
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1154709111 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 1003 (North Dakota) | Primary |
Provider Name | Andrea Burckhard |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1538486154 PECOS PAC ID: 1557499704 Enrollment ID: I20100507000509 |
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