Provider Demographics
NPI:1083070213
Name:INFINITY CHIROPRACTIC
Entity Type:Organization
Organization Name:INFINITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-454-9393
Mailing Address - Street 1:1360 UNIVERSITY AVE W
Mailing Address - Street 2:STE 313
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4086
Mailing Address - Country:US
Mailing Address - Phone:612-823-3409
Mailing Address - Fax:
Practice Address - Street 1:515 W LAKE ST
Practice Address - Street 2:SUITE F
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2962
Practice Address - Country:US
Practice Address - Phone:612-823-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty