Provider Demographics
NPI:1376614081
Name:FOR YOUR WELL BEING CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:FOR YOUR WELL BEING CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARIHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-770-5433
Mailing Address - Street 1:2479 E. COUNTY RD. E
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-770-5433
Mailing Address - Fax:651-777-1733
Practice Address - Street 1:2479 E. COUNTY RD. E
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110
Practice Address - Country:US
Practice Address - Phone:651-770-5433
Practice Address - Fax:651-777-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN210J0MAOtherBCBS PROVIDER ID
MN209J1FOOtherBCBS CLINIC ID