Provider Demographics
NPI:1164555371
Name:MEISEL CHIROPRACTIC CENTER, PA
Entity Type:Organization
Organization Name:MEISEL CHIROPRACTIC CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-452-5142
Mailing Address - Street 1:856 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-5111
Mailing Address - Country:US
Mailing Address - Phone:507-452-5142
Mailing Address - Fax:507-452-8693
Practice Address - Street 1:856 W 5TH ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-5111
Practice Address - Country:US
Practice Address - Phone:507-452-5142
Practice Address - Fax:507-452-8693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN111228700OtherMEDICAL ASSISTANCE
MN350001901Medicare ID - Type Unspecified
MNT39904Medicare UPIN