Provider Demographics
NPI:1376591792
Name:CHRISTIAN NEUROLOGY ASSOCIATES OF MINNESOTA, PA
Entity Type:Organization
Organization Name:CHRISTIAN NEUROLOGY ASSOCIATES OF MINNESOTA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:COWENS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:218-748-7701
Mailing Address - Street 1:3920 13TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3675
Mailing Address - Country:US
Mailing Address - Phone:218-263-7540
Mailing Address - Fax:866-732-0699
Practice Address - Street 1:901 9TH ST N
Practice Address - Street 2:SUITE 317
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2348
Practice Address - Country:US
Practice Address - Phone:218-748-7701
Practice Address - Fax:218-748-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty