Provider Demographics
NPI:1760629992
Name:SIMPLY CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:SIMPLY CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-207-3112
Mailing Address - Street 1:10037 TAPESTRY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-6000
Mailing Address - Country:US
Mailing Address - Phone:612-207-3112
Mailing Address - Fax:
Practice Address - Street 1:10037 TAPESTRY RD
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-6000
Practice Address - Country:US
Practice Address - Phone:612-207-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4045261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center