Provider Demographics
NPI:1114460888
Name:ANCHORED CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ANCHORED CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-563-7447
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-0163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1060 CURVE CREST BLVD W
Practice Address - Street 2:SUITE 102
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5093
Practice Address - Country:US
Practice Address - Phone:715-563-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty