Provider Demographics
NPI:1073731527
Name:CULTURAL CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:CULTURAL CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNEAU
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-522-9536
Mailing Address - Street 1:2009 PLYMOUTH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3712
Mailing Address - Country:US
Mailing Address - Phone:612-522-9536
Mailing Address - Fax:612-522-9537
Practice Address - Street 1:2009 PLYMOUTH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3712
Practice Address - Country:US
Practice Address - Phone:612-522-9536
Practice Address - Fax:612-522-9537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty