Provider Demographics
NPI:1851824973
Name:AYEN CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:AYEN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-358-9729
Mailing Address - Street 1:1050 MAPLEBECK PL NE
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:MN
Mailing Address - Zip Code:55920-1584
Mailing Address - Country:US
Mailing Address - Phone:507-358-9729
Mailing Address - Fax:
Practice Address - Street 1:1067 4TH ST NE
Practice Address - Street 2:SUITE 200
Practice Address - City:BYRON
Practice Address - State:MN
Practice Address - Zip Code:55920-5002
Practice Address - Country:US
Practice Address - Phone:507-358-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty