Provider Demographics
NPI:1326229063
Name:METRONET CHIROPRACTC SERVICES, P.A
Entity Type:Organization
Organization Name:METRONET CHIROPRACTC SERVICES, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FOKUMLAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-560-0712
Mailing Address - Street 1:7420 UNITY AVE N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3143
Mailing Address - Country:US
Mailing Address - Phone:763-560-0712
Mailing Address - Fax:763-560-9182
Practice Address - Street 1:7420 UNITY AVE N
Practice Address - Street 2:SUITE 204
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3143
Practice Address - Country:US
Practice Address - Phone:763-560-0712
Practice Address - Fax:763-560-9182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty