Provider Demographics
NPI:1598959793
Name:HEALING ARTS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:HEALING ARTS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:PAAPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-451-9070
Mailing Address - Street 1:3240 15TH ST S STE C
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6188
Mailing Address - Country:US
Mailing Address - Phone:701-451-9070
Mailing Address - Fax:701-364-5318
Practice Address - Street 1:3290 20TH ST SW
Practice Address - Street 2:SUITE B
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-5923
Practice Address - Country:US
Practice Address - Phone:701-451-9070
Practice Address - Fax:701-364-5318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12243Medicaid
MN929649200Medicaid
ND22720Medicare PIN