Provider Demographics
NPI:1134288913
Name:DISCOVER CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-746-7533
Mailing Address - Street 1:6550 YORK AVE S
Mailing Address - Street 2:STE 216
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2347
Mailing Address - Country:US
Mailing Address - Phone:952-746-7533
Mailing Address - Fax:952-746-7536
Practice Address - Street 1:6550 YORK AVE S
Practice Address - Street 2:STE 216
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2347
Practice Address - Country:US
Practice Address - Phone:952-746-7533
Practice Address - Fax:952-746-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4583261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center