Provider Demographics
NPI:1760507198
Name:BEYOND CHIROPRACTIC
Entity Type:Organization
Organization Name:BEYOND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-288-1988
Mailing Address - Street 1:539 BIELENBERG DR
Mailing Address - Street 2:SUITE 125
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4436
Mailing Address - Country:US
Mailing Address - Phone:651-288-1988
Mailing Address - Fax:
Practice Address - Street 1:539 BIELENBERG DR
Practice Address - Street 2:SUITE 125
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4436
Practice Address - Country:US
Practice Address - Phone:651-288-1988
Practice Address - Fax:651-288-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4927111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty