CHIROPRACTIC HEALTH CENTER P A

Provider Demographics

• NPI: 1376757682
• Name: CHIROPRACTIC HEALTH CENTER P A
• Entity Type: Organization
• Organization Name: CHIROPRACTIC HEALTH CENTER P A
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: COREY
• Authorized Official - Last Name: MILBRANDT
• Authorized Official - Credentials: DC
• Authorized Official - Phone: 218-628-0646
• Mailing Address - Street 1: 925 E SUPERIOR ST STE 112
• Mailing Address - City: DULUTH
• Mailing Address - State: MN
• Mailing Address - Zip Code: 55802-2253
• Mailing Address - Country: US
• Mailing Address - Phone: 218-628-0646
• Mailing Address - Fax: 218-628-1889
• Practice Address - Street 1: 925 E SUPERIOR ST STE 112
• Practice Address - City: DULUTH
• Practice Address - State: MN
• Practice Address - Zip Code: 55802-2253
• Practice Address - Country: US
• Practice Address - Phone: 218-628-0646
• Practice Address - Fax: 218-628-1889
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-05-09
• Last Update Date: 2023-09-28

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	111N00000X	Chiropractic Providers	Chiropractor		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MN	565319300	Medicaid
MN	63G93CH	Other	BLUE CROSS GROUP #
MN	616826400	Medicaid
MN	1255337937	Other	DR KARA MCGILLIVRAY NPI
MN	565319300	Medicaid
WI	111N00000X 3191	Other	TAXONOMIES DR KARA MCGILL
MN	111N00000X 0357	Other	TAXONOMIES DR KARA MCGILL
MN	1699771337	Other	DR GREG MCGILLIVRAY NPI
MN	111N00000X 3296	Other	TAXONOMIES DR GREG MCGILL
MN	4442055 CCMI	Other	DR GREG MCGILLIVRAY
MN	63G94MC BLUE CROSS	Other	DR GREG MCGILLIVRAY BLUE
MN	63G95MC BLUE CROSS	Other	DR KARA MCGILLIVRAY BLUE
WI	111N00000X 3191	Other	TAXONOMIES DR KARA MCGILL
MN	63G94MC BLUE CROSS	Other	DR GREG MCGILLIVRAY BLUE
MN	1255337937	Other	DR KARA MCGILLIVRAY NPI
MN	350055889	Medicare ID - Type Unspecified	DR GREG MCGILLIVRAY RRMED
MN	350003295	Medicare ID - Type Unspecified	DR KARA MCGILLIVRAY ID
MN	4442055 CCMI	Other	DR GREG MCGILLIVRAY
MN	350055890	Medicare ID - Type Unspecified	DR KARA MCGILLIVRAY RRMED
MN	CK4826	Medicare ID - Type Unspecified	RR MEDICARE GROUP NUMBER