Provider Demographics
NPI:1124562616
Name:CAPITOL HEALTH & INJURY CENTER, P.A.
Entity Type:Organization
Organization Name:CAPITOL HEALTH & INJURY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HURKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-771-2012
Mailing Address - Street 1:1973 SLOAN PL STE 250
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2181
Mailing Address - Country:US
Mailing Address - Phone:651-771-2012
Mailing Address - Fax:651-771-8747
Practice Address - Street 1:1973 SLOAN PL STE 250
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2181
Practice Address - Country:US
Practice Address - Phone:651-771-2012
Practice Address - Fax:651-771-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty