Provider Demographics
NPI:1518345016
Name:WAIND CHIROPRACTIC & ACUPUNCTURE
Entity Type:Organization
Organization Name:WAIND CHIROPRACTIC & ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WAIND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-746-5477
Mailing Address - Street 1:2506A S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6703
Mailing Address - Country:US
Mailing Address - Phone:701-746-5477
Mailing Address - Fax:
Practice Address - Street 1:2506A S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6703
Practice Address - Country:US
Practice Address - Phone:701-746-5477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND11793Medicaid
21585OtherND BC/BS
350054193OtherRR MEDICARE
U88526Medicare UPIN
350054193OtherRR MEDICARE