Provider Demographics
NPI:1467964684
Name:CHIROPRACTIC ARTS CLINIC, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC ARTS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-852-0158
Mailing Address - Street 1:1001 20TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6446
Mailing Address - Country:US
Mailing Address - Phone:701-852-0158
Mailing Address - Fax:701-852-5630
Practice Address - Street 1:1001 20TH AVE SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6446
Practice Address - Country:US
Practice Address - Phone:701-852-0158
Practice Address - Fax:701-852-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND740111N00000X
ND716111N00000X
ND730111N00000X
ND867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty