Provider Demographics
NPI:1851532949
Name:RENEWED HOPE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:RENEWED HOPE CHIROPRACTIC, LLC
Other - Org Name:RENEWED HOPE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRET
Authorized Official - Middle Name:
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-738-0990
Mailing Address - Street 1:1726 S WASHINGTON ST
Mailing Address - Street 2:STE 79
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6370
Mailing Address - Country:US
Mailing Address - Phone:701-738-0990
Mailing Address - Fax:701-738-0992
Practice Address - Street 1:1726 S WASHINGTON ST
Practice Address - Street 2:STE 79
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6370
Practice Address - Country:US
Practice Address - Phone:701-738-0990
Practice Address - Fax:701-738-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty