Provider Demographics
NPI:1215226600
Name:CARDINAL CHIROPRACTIC OF ALEXANDRIA LLC
Entity Type:Organization
Organization Name:CARDINAL CHIROPRACTIC OF ALEXANDRIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOVEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-762-9000
Mailing Address - Street 1:460 NORTHSIDE DR NE STE 10
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2486
Mailing Address - Country:US
Mailing Address - Phone:320-762-9000
Mailing Address - Fax:
Practice Address - Street 1:460 NORTHSIDE DR NE STE 10
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2486
Practice Address - Country:US
Practice Address - Phone:320-762-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4377261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center