Provider Demographics
NPI:1740207703
Name:KEY CHIROPRACTIC, LTD
Entity Type:Organization
Organization Name:KEY CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-770-8200
Mailing Address - Street 1:2597 7TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3104
Mailing Address - Country:US
Mailing Address - Phone:651-770-8200
Mailing Address - Fax:
Practice Address - Street 1:2597 7TH AVE E
Practice Address - Street 2:
Practice Address - City:NORTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-3104
Practice Address - Country:US
Practice Address - Phone:651-770-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN017R6KEOtherBLUE CROSS & BLUE SHIELD
MN351523100Medicaid
MN351523100Medicaid