Provider Demographics
NPI:1588202139
Name:HARKINS CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:HARKINS CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-710-9905
Mailing Address - Street 1:15600 35TH AVE N STE 101
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1396
Mailing Address - Country:US
Mailing Address - Phone:763-710-9905
Mailing Address - Fax:877-220-0344
Practice Address - Street 1:15600 35TH AVE N STE 101
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1396
Practice Address - Country:US
Practice Address - Phone:763-710-9905
Practice Address - Fax:877-220-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty