Provider Demographics
NPI:1083836258
Name:UPTOWN CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:UPTOWN CHIROPRACTIC, LLC
Other - Org Name:UPTOWN CHIRO
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANKLIN-KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-823-9355
Mailing Address - Street 1:3009 GARFIELD AVENUE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408
Mailing Address - Country:US
Mailing Address - Phone:612-823-9355
Mailing Address - Fax:612-827-5049
Practice Address - Street 1:3009 GARFIELD AVENUE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408
Practice Address - Country:US
Practice Address - Phone:612-823-9355
Practice Address - Fax:612-827-5049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77039Medicare UPIN