Provider Demographics
NPI:1104376169
Name:HJORT CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:HJORT CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HJORT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-251-3450
Mailing Address - Street 1:3700 W DIVISION ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4031
Mailing Address - Country:US
Mailing Address - Phone:320-251-3450
Mailing Address - Fax:320-203-7594
Practice Address - Street 1:3700 W DIVISION ST STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4031
Practice Address - Country:US
Practice Address - Phone:320-251-3450
Practice Address - Fax:320-203-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty