Provider Demographics
NPI:1598936270
Name:LAURA J. HULSEBUS P.A.
Entity Type:Organization
Organization Name:LAURA J. HULSEBUS P.A.
Other - Org Name:HULSEBUS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HULSEBUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-849-0444
Mailing Address - Street 1:206 WEST WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ST. PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082
Mailing Address - Country:US
Mailing Address - Phone:507-943-2400
Mailing Address - Fax:
Practice Address - Street 1:206 WEST WALNUT ST
Practice Address - Street 2:
Practice Address - City:ST. PETER
Practice Address - State:MN
Practice Address - Zip Code:56082
Practice Address - Country:US
Practice Address - Phone:507-943-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty