Provider Demographics
NPI:1578569232
Name:HEALTHPLUS CHIROPRACTIC
Entity Type:Organization
Organization Name:HEALTHPLUS CHIROPRACTIC
Other - Org Name:CEBTER FOR SPINAL DECOMPRESSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-535-4342
Mailing Address - Street 1:4080 W BROADWAY AVE
Mailing Address - Street 2:STE 128
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5605
Mailing Address - Country:US
Mailing Address - Phone:763-535-4342
Mailing Address - Fax:763-533-2526
Practice Address - Street 1:4080 W BROADWAY AVE
Practice Address - Street 2:STE 128
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-5605
Practice Address - Country:US
Practice Address - Phone:763-535-4342
Practice Address - Fax:763-533-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN83369Medicare UPIN
MN453177094751Medicare UPIN
MN293J7SCMedicare UPIN