Provider Demographics
NPI:1467900688
Name:ACHIEVE CHIROPRACTIC AND WELLNESS, PA
Entity Type:Organization
Organization Name:ACHIEVE CHIROPRACTIC AND WELLNESS, PA
Other - Org Name:ACHIEVE WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROD
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:OCHSENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-762-2055
Mailing Address - Street 1:114 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-1304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 5TH AVE W
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1304
Practice Address - Country:US
Practice Address - Phone:320-762-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4768261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center