Provider Demographics
NPI:1619168200
Name:BOSCHEE CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:BOSCHEE CHIROPRACTIC, LTD
Other - Org Name:VALLEY WEST CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BOSCHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-888-5805
Mailing Address - Street 1:12300 SINGLETREE LANE
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344
Mailing Address - Country:US
Mailing Address - Phone:952-888-5805
Mailing Address - Fax:952-903-2816
Practice Address - Street 1:10700 NORMANDALE BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-2700
Practice Address - Country:US
Practice Address - Phone:952-888-5805
Practice Address - Fax:952-888-7563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003458261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205913274OtherNPI
MN266219100Medicaid
669507Medicare UPIN
MN266219100Medicaid