Provider Demographics
NPI:1043873821
Name:CARDER CHIROPRACTIC AND HEALTH PLLC
Entity Type:Organization
Organization Name:CARDER CHIROPRACTIC AND HEALTH PLLC
Other - Org Name:LAKEVILLE SPINE & HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-985-8808
Mailing Address - Street 1:20176 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-6855
Mailing Address - Country:US
Mailing Address - Phone:952-985-8808
Mailing Address - Fax:
Practice Address - Street 1:20176 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6855
Practice Address - Country:US
Practice Address - Phone:952-985-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty