Provider Demographics
NPI:1518037100
Name:CENTER FOR ALTERNATIVE HEALTH AND CHIROPRACTIC PA
Entity Type:Organization
Organization Name:CENTER FOR ALTERNATIVE HEALTH AND CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-541-5669
Mailing Address - Street 1:17 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7505
Mailing Address - Country:US
Mailing Address - Phone:952-541-5669
Mailing Address - Fax:952-927-0178
Practice Address - Street 1:17 10TH AVE S
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7505
Practice Address - Country:US
Practice Address - Phone:952-541-5669
Practice Address - Fax:952-927-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2285111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C05283Medicare UPIN
MN44-87093OtherMEDICA
MN4C436CEOtherBCBS CLINIC NUMBER
MN36432OtherHEALTH PARTNERS
MNU12989Medicare UPIN