Vaagenes Chiropractic, Llc | |
470 Highway 96 W Suite 160 Shoreview MN 55126-1996 | |
(651) 415-0446 | |
(651) 415-0447 |
Full Name | Vaagenes Chiropractic, Llc |
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Speciality | Clinic/Center |
Location | 470 Highway 96 W, Shoreview, Minnesota |
Authorized Official Name and Position | Timothy Jon Vaagenes (OWNER) |
Authorized Official Contact | 6514150446 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vaagenes Chiropractic, Llc 2508 Highway 70 Po Box 385 Braham MN 55006-3759 Ph: (651) 415-0446 | Vaagenes Chiropractic, Llc 470 Highway 96 W Suite 160 Shoreview MN 55126-1996 Ph: (651) 415-0446 |
NPI Number | 1669811295 |
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Provider Enumeration Date | 06/17/2013 |
Last Update Date | 06/25/2013 |
Medicare PECOS PAC ID | 3971742826 |
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Medicare Enrollment ID | O20130625000637 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669811295 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 3144 (Minnesota) | Primary |
Provider Name | Timothy J Vaagenes |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1376697102 PECOS PAC ID: 1658277132 Enrollment ID: I20031208000679 |
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