Provider Demographics
NPI:1477317196
Name:SUMMIT CHIROPRACTIC CARE PLLC
Entity Type:Organization
Organization Name:SUMMIT CHIROPRACTIC CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-391-0499
Mailing Address - Street 1:324 BROADWAY ST STE 218
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4771
Mailing Address - Country:US
Mailing Address - Phone:320-391-0499
Mailing Address - Fax:320-291-0501
Practice Address - Street 1:324 BROADWAY ST STE 218
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4771
Practice Address - Country:US
Practice Address - Phone:320-391-0499
Practice Address - Fax:320-291-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty