Provider Demographics
NPI:1134459571
Name:BELLE PLAINE CHIROPRACTIC HEALTH AND WELLNESS CENTER, PA
Entity Type:Organization
Organization Name:BELLE PLAINE CHIROPRACTIC HEALTH AND WELLNESS CENTER, PA
Other - Org Name:BELLE PLAINE CHIROPRACTIC, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-873-6370
Mailing Address - Street 1:200 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011-1616
Mailing Address - Country:US
Mailing Address - Phone:952-873-6370
Mailing Address - Fax:952-873-6375
Practice Address - Street 1:200 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011-1616
Practice Address - Country:US
Practice Address - Phone:952-873-6370
Practice Address - Fax:952-873-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-40271OtherMEDICA
MN766-717500Medicaid
MN00B90MEOtherBCBS
MNCC00522OtherCHIROCARE OF MINNESOTA
MN35-000-1725Medicare UPIN