Provider Demographics
NPI:1609920826
Name:FINK FAMILY CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:FINK FAMILY CHIROPRACTIC, PA
Other - Org Name:INTEGRITY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-428-2247
Mailing Address - Street 1:18556 PILOT KNOB RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8674
Mailing Address - Country:US
Mailing Address - Phone:651-428-2247
Mailing Address - Fax:651-463-2007
Practice Address - Street 1:18598 ELK RIVER TRL
Practice Address - Street 2:SUITE 103
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-8674
Practice Address - Country:US
Practice Address - Phone:651-428-2247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN313P2INOtherBCBS
MN758790200Medicaid