Provider Demographics
NPI:1114104759
Name:FAMILY WEST CHIROPRACTIC PA.
Entity Type:Organization
Organization Name:FAMILY WEST CHIROPRACTIC PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEPFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-938-3334
Mailing Address - Street 1:8800 W. HWY 7 STE. 222
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3927
Mailing Address - Country:US
Mailing Address - Phone:952-938-3334
Mailing Address - Fax:
Practice Address - Street 1:8800 HIGHWAY 7 STE 222
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3927
Practice Address - Country:US
Practice Address - Phone:952-938-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty