Provider Demographics
NPI:1093043929
Name:KRAMER CHIROPRACTIC WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:KRAMER CHIROPRACTIC WELLNESS CENTER PLLC
Other - Org Name:MONTGOMERY FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:NATE
Authorized Official - Last Name:MOLITOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-364-7500
Mailing Address - Street 1:317 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MN
Mailing Address - Zip Code:56069-1603
Mailing Address - Country:US
Mailing Address - Phone:507-364-7500
Mailing Address - Fax:507-364-7444
Practice Address - Street 1:317 1ST ST S
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:MN
Practice Address - Zip Code:56069-1603
Practice Address - Country:US
Practice Address - Phone:507-364-7500
Practice Address - Fax:507-364-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5204261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service