Provider Demographics
NPI:1750683355
Name:CHIROPRACTIC ASSOCIATES
Entity Type:Organization
Organization Name:CHIROPRACTIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:OPDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-269-5000
Mailing Address - Street 1:544 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-2106
Mailing Address - Country:US
Mailing Address - Phone:320-269-5000
Mailing Address - Fax:320-269-3030
Practice Address - Street 1:544 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-2106
Practice Address - Country:US
Practice Address - Phone:320-269-5000
Practice Address - Fax:320-269-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty