Provider Demographics
NPI:1639552136
Name:ADVANCED CARE CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:ADVANCED CARE CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:OSVOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-893-8900
Mailing Address - Street 1:14001 RIDGEDALE DR
Mailing Address - Street 2:SUITE 390
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1753
Mailing Address - Country:US
Mailing Address - Phone:952-893-8900
Mailing Address - Fax:952-893-7399
Practice Address - Street 1:14001 RIDGEDALE DR
Practice Address - Street 2:SUITE 390
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1753
Practice Address - Country:US
Practice Address - Phone:952-893-8900
Practice Address - Fax:952-893-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty