Provider Demographics
NPI:1568794691
Name:CHIROPRACTIC HEALTH SOLUTIONS PLLC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH SOLUTIONS PLLC
Other - Org Name:HEALTHSOURCE OF HUGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-334-2268
Mailing Address - Street 1:14643 MERCANTILE DR N
Mailing Address - Street 2:110
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-4552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14643 MERCANTILE DR N
Practice Address - Street 2:110
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-4552
Practice Address - Country:US
Practice Address - Phone:651-334-2268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty