Provider Demographics
NPI:1457470445
Name:POESCHEL CHIROPRACTIC PSC
Entity Type:Organization
Organization Name:POESCHEL CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:POESCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-756-7380
Mailing Address - Street 1:1818 WOODDALE DR
Mailing Address - Street 2:STE #100
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2983
Mailing Address - Country:US
Mailing Address - Phone:651-756-7380
Mailing Address - Fax:651-340-9765
Practice Address - Street 1:1818 WOODDALE DR
Practice Address - Street 2:STE #100
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2983
Practice Address - Country:US
Practice Address - Phone:651-756-7380
Practice Address - Fax:651-340-9765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty