Y-chiropractic | |
10700 Highway 55 Suite 100 Plymouth MN 55441-6100 | |
(763) 543-9080 | |
(763) 543-9082 |
Full Name | Y-chiropractic |
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Speciality | Clinic/Center |
Location | 10700 Highway 55, Plymouth, Minnesota |
Authorized Official Name and Position | Paul Daeboo Moon (CHIROPRACTOR/OWNER) |
Authorized Official Contact | 7635439080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Y-chiropractic 10700 Highway 55 Suite 100 Plymouth MN 55441-6100 Ph: (763) 543-9080 | Y-chiropractic 10700 Highway 55 Suite 100 Plymouth MN 55441-6100 Ph: (763) 543-9080 |
NPI Number | 1275711764 |
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Provider Enumeration Date | 02/06/2008 |
Last Update Date | 07/02/2008 |
Medicare PECOS PAC ID | 0547287617 |
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Medicare Enrollment ID | O20051027000924 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275711764 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Paul D Moon |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1871663815 PECOS PAC ID: 6709803877 Enrollment ID: I20051027000948 |
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