Provider Demographics
NPI:1467736231
Name:NIELSON FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NIELSON FAMILY CHIROPRACTIC LLC
Other - Org Name:DAVIS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:NIELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-925-4085
Mailing Address - Street 1:5050 W 36TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5470
Mailing Address - Country:US
Mailing Address - Phone:952-925-4085
Mailing Address - Fax:952-925-1394
Practice Address - Street 1:5050 W 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5470
Practice Address - Country:US
Practice Address - Phone:952-925-4085
Practice Address - Fax:952-925-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty