Provider Demographics
NPI:1598293201
Name:INSPIRE LIFE CHIROPRACTIC CENTER, PLLC
Entity Type:Organization
Organization Name:INSPIRE LIFE CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:KRUG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-724-5229
Mailing Address - Street 1:750 MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3765
Mailing Address - Country:US
Mailing Address - Phone:651-756-1218
Mailing Address - Fax:
Practice Address - Street 1:750 MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55118-3765
Practice Address - Country:US
Practice Address - Phone:651-756-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty