Provider Demographics
NPI:1700010766
Name:VOLKMANN CHIROPRACTIC
Entity Type:Organization
Organization Name:VOLKMANN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-429-3500
Mailing Address - Street 1:3634 WHITE BEAR AVE N
Mailing Address - Street 2:300
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-4746
Mailing Address - Country:US
Mailing Address - Phone:651-429-3500
Mailing Address - Fax:651-429-3515
Practice Address - Street 1:3634 WHITE BEAR AVE N
Practice Address - Street 2:300
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-4746
Practice Address - Country:US
Practice Address - Phone:651-429-3500
Practice Address - Fax:651-429-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5198261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service