Provider Demographics
NPI:1619043726
Name:LEVIN AND CHELLEN CHIROPRACTIC
Entity Type:Organization
Organization Name:LEVIN AND CHELLEN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELS
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:CHELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-474-1777
Mailing Address - Street 1:4144 COUNTY ROAD 101
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4066
Mailing Address - Country:US
Mailing Address - Phone:952-474-1777
Mailing Address - Fax:
Practice Address - Street 1:4144 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4066
Practice Address - Country:US
Practice Address - Phone:952-474-1777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN446279300Medicaid
MN01D99LEOtherBLUECROSS BLUESHIELD
MNC03201Medicare PIN
MNU92867Medicare UPIN