Provider Demographics
NPI:1639333750
Name:GEARY CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:GEARY CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RODNEY
Authorized Official - Last Name:GEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-882-1965
Mailing Address - Street 1:2999 COUNTY ROAD 42 W
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-6994
Mailing Address - Country:US
Mailing Address - Phone:952-882-1965
Mailing Address - Fax:952-882-1969
Practice Address - Street 1:2999 COUNTY ROAD 42 W
Practice Address - Street 2:SUITE 212
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-6994
Practice Address - Country:US
Practice Address - Phone:952-882-1965
Practice Address - Fax:952-882-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN002877261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service