Provider Demographics
NPI:1639373319
Name:HEALING TOUCH CHIROPRACTIC
Entity Type:Organization
Organization Name:HEALING TOUCH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-405-3990
Mailing Address - Street 1:1570 CENTURY PT
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-1926
Mailing Address - Country:US
Mailing Address - Phone:651-405-3990
Mailing Address - Fax:651-405-6627
Practice Address - Street 1:1570 CENTURY PT
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1926
Practice Address - Country:US
Practice Address - Phone:651-405-3990
Practice Address - Fax:651-405-6627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4141111N00000X
MNK331197590107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10G28HEOtherGROUP BCBS
MN10G29SMOtherBCBS
MN534G2PEOtherBCBS
MN534G2PEOtherBCBS
MN10G28HEOtherGROUP BCBS