Provider Demographics
NPI:1477638310
Name:SHARI E. AULTMAN DC
Entity Type:Organization
Organization Name:SHARI E. AULTMAN DC
Other - Org Name:HEALING HANDS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:AULTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-326-0046
Mailing Address - Street 1:1891 E US HWY 2
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3278
Mailing Address - Country:US
Mailing Address - Phone:218-326-0046
Mailing Address - Fax:218-327-1543
Practice Address - Street 1:1891 E US HWY 2
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3278
Practice Address - Country:US
Practice Address - Phone:218-326-0046
Practice Address - Fax:218-327-1543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN432910400Medicaid
MNC02589Medicare PIN
MN432910400Medicaid