Provider Demographics
NPI:1831301753
Name:CASPERS CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:CASPERS CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:CASPERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-587-2292
Mailing Address - Street 1:103 3RD AV NW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350
Mailing Address - Country:US
Mailing Address - Phone:320-587-2292
Mailing Address - Fax:320-587-7588
Practice Address - Street 1:103 3RD AV NW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350
Practice Address - Country:US
Practice Address - Phone:320-587-2292
Practice Address - Fax:320-587-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1255466777OtherINDIVIDUAL NPI
MN53F33CAOtherBLUE CROSS GROUP NUMBER
MN827319700Medicaid
MN1255466777OtherINDIVIDUAL NPI
MN350002437Medicare ID - Type UnspecifiedMEDICARE ID