Provider Demographics
NPI:1467517953
Name:POWER WITHIN CHIROPRACTIC PA
Entity Type:Organization
Organization Name:POWER WITHIN CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETHANIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-437-6778
Mailing Address - Street 1:1355 SOUTH FRONTAGE ROAD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2482
Mailing Address - Country:US
Mailing Address - Phone:651-437-6778
Mailing Address - Fax:651-437-6778
Practice Address - Street 1:1355 SOUTH FRONTAGE ROAD
Practice Address - Street 2:SUITE 120
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2482
Practice Address - Country:US
Practice Address - Phone:651-437-6778
Practice Address - Fax:651-437-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN078H6P0OtherBCBS
MN117003OtherHEALTH PARTNERS
MN078H6P0OtherBCBS
MN078H6P0OtherBCBS