Provider Demographics
NPI:1750671277
Name:ZEN CHIROPRACTIC INCOPORATED
Entity Type:Organization
Organization Name:ZEN CHIROPRACTIC INCOPORATED
Other - Org Name:ZEN HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATSUDA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-500-8733
Mailing Address - Street 1:4570 WEST 77TH STREET
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:612-886-7763
Mailing Address - Fax:612-886-7763
Practice Address - Street 1:4570 WEST 77TH STREET
Practice Address - Street 2:SUITE 140
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-500-8733
Practice Address - Fax:763-892-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5320111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty