Provider Demographics
NPI:1760482103
Name:SANTORI, MICHAEL F (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:SANTORI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7155 80TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3033
Mailing Address - Country:US
Mailing Address - Phone:651-459-5585
Mailing Address - Fax:
Practice Address - Street 1:7155 80TH ST S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3033
Practice Address - Country:US
Practice Address - Phone:651-459-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN72482700Medicaid
MNT39499Medicare UPIN
MN350002668Medicare ID - Type Unspecified