Provider Demographics
NPI:1760185128
Name:CARDINAL CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:CARDINAL CHIROPRACTIC CENTER, LLC
Other - Org Name:CARDINAL CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-644-7005
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:MCGREGOR
Mailing Address - State:MN
Mailing Address - Zip Code:55760-0003
Mailing Address - Country:US
Mailing Address - Phone:218-644-7005
Mailing Address - Fax:
Practice Address - Street 1:94 N MADDY ST # 3
Practice Address - Street 2:
Practice Address - City:MCGREGOR
Practice Address - State:MN
Practice Address - Zip Code:55760-5007
Practice Address - Country:US
Practice Address - Phone:218-644-7005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty