Provider Demographics
NPI:1033306147
Name:GREGG M POQUETTE B.S. D.C. P.A.
Entity Type:Organization
Organization Name:GREGG M POQUETTE B.S. D.C. P.A.
Other - Org Name:HELPING HANDS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:POQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-452-3900
Mailing Address - Street 1:4660 SLATER RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-4047
Mailing Address - Country:US
Mailing Address - Phone:651-452-3900
Mailing Address - Fax:
Practice Address - Street 1:4660 SLATER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4047
Practice Address - Country:US
Practice Address - Phone:651-452-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2402261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN344328100Medicaid
MN51364POOtherBLUE CROSS
MNC01490Medicare UPIN