Provider Demographics
NPI:1659663722
Name:PEARSON, MICHAEL DEAN (DR OF CHIROPRACTIC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DEAN
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DR OF CHIROPRACTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 166TH ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56151-2040
Mailing Address - Country:US
Mailing Address - Phone:507-227-5376
Mailing Address - Fax:
Practice Address - Street 1:1024 166TH ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MN
Practice Address - Zip Code:56151-2040
Practice Address - Country:US
Practice Address - Phone:507-227-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor