Provider Demographics
NPI:1497297238
Name:NORTHEAST CHIROPRACTIC
Entity Type:Organization
Organization Name:NORTHEAST CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIFELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-378-1050
Mailing Address - Street 1:34 13TH AVE NE
Mailing Address - Street 2:SUITE B002C
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1002
Mailing Address - Country:US
Mailing Address - Phone:612-378-1050
Mailing Address - Fax:
Practice Address - Street 1:34 13TH AVE NE
Practice Address - Street 2:SUITE B002C
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1002
Practice Address - Country:US
Practice Address - Phone:612-378-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty