Provider Demographics
NPI:1689031791
Name:EMPOWER CHIROPRACTIC AND WELLNESS CENTER P.L.L.C.
Entity Type:Organization
Organization Name:EMPOWER CHIROPRACTIC AND WELLNESS CENTER P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-220-0111
Mailing Address - Street 1:373 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3061
Mailing Address - Country:US
Mailing Address - Phone:952-474-3359
Mailing Address - Fax:
Practice Address - Street 1:373 GEORGE ST
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-3061
Practice Address - Country:US
Practice Address - Phone:952-474-3359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6179111N00000X
MN6153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty