Provider Demographics
NPI:1265640106
Name:NOHNER, ERIC RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:RICHARD
Last Name:NOHNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 PINE ARBOR ALCOVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4565
Mailing Address - Country:US
Mailing Address - Phone:651-230-6366
Mailing Address - Fax:
Practice Address - Street 1:6910 PINE ARBOR ALCOVE S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4565
Practice Address - Country:US
Practice Address - Phone:651-230-6366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN381R5NOOtherBLUE CROSS
MN381R5NOOtherBLUE CROSS
MNU96644Medicare UPIN