Provider Demographics
NPI:1518990043
Name:PREFERRED CHOICE CHIROPRACTIC
Entity Type:Organization
Organization Name:PREFERRED CHOICE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTURFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-543-1103
Mailing Address - Street 1:PO BOX 737
Mailing Address - Street 2:
Mailing Address - City:HOWARD LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55349-0737
Mailing Address - Country:US
Mailing Address - Phone:320-543-1103
Mailing Address - Fax:320-543-1105
Practice Address - Street 1:1116 SIXTH STREET
Practice Address - Street 2:
Practice Address - City:HOWARD LAKE
Practice Address - State:MN
Practice Address - Zip Code:55349-0737
Practice Address - Country:US
Practice Address - Phone:320-543-1103
Practice Address - Fax:320-543-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03221Medicare ID - Type UnspecifiedGROUP