Provider Demographics
NPI:1578804316
Name:WIEGEL CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:WIEGEL CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-202-4747
Mailing Address - Street 1:407 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5535
Mailing Address - Country:US
Mailing Address - Phone:701-425-0797
Mailing Address - Fax:701-425-0303
Practice Address - Street 1:407 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5535
Practice Address - Country:US
Practice Address - Phone:701-202-4747
Practice Address - Fax:701-663-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND921111N00000X
ND922111N00000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty