Provider Demographics
NPI:1477212660
Name:BEYOND WELLNESS CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:BEYOND WELLNESS CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:A FOUST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-652-3919
Mailing Address - Street 1:5773 EGAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4917
Mailing Address - Country:US
Mailing Address - Phone:952-652-3919
Mailing Address - Fax:
Practice Address - Street 1:5773 EGAN DR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4917
Practice Address - Country:US
Practice Address - Phone:952-652-3919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty