Provider Demographics
NPI:1114296993
Name:LEVERNIER CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:LEVERNIER CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVERNIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-554-6774
Mailing Address - Street 1:638 PARK VALLEY DR W
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7741
Mailing Address - Country:US
Mailing Address - Phone:612-554-6774
Mailing Address - Fax:
Practice Address - Street 1:8441 WAYZATA BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1344
Practice Address - Country:US
Practice Address - Phone:763-307-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4847111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty