Provider Demographics
NPI:1376820191
Name:EMPOWERED FAMILY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:EMPOWERED FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-208-4538
Mailing Address - Street 1:2625 HWY 14 W STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7597
Mailing Address - Country:US
Mailing Address - Phone:507-208-4538
Mailing Address - Fax:
Practice Address - Street 1:2625 HWY 14 W STE B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-7597
Practice Address - Country:US
Practice Address - Phone:507-208-4538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty