Provider Demographics
NPI:1225251770
Name:ABELER CHIROPRACTIC CLINIC, PA
Entity Type:Organization
Organization Name:ABELER CHIROPRACTIC CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ABELER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-421-3722
Mailing Address - Street 1:600 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2527
Mailing Address - Country:US
Mailing Address - Phone:763-421-3722
Mailing Address - Fax:763-421-1476
Practice Address - Street 1:600 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2527
Practice Address - Country:US
Practice Address - Phone:763-421-3722
Practice Address - Fax:763-421-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00022ABOtherBLUE CROSS BLUE SHIELD
MN543820900Medicaid
MN610135800OtherUS DEPT OF LABOR
MN4426063OtherSTATE TAX ID
MNC03161Medicare ID - Type UnspecifiedMEDICARE NUMBER
MN543820900Medicaid