Provider Demographics
NPI:1861677809
Name:A.B.L.E. CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:A.B.L.E. CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-953-9898
Mailing Address - Street 1:13335 PALOMINO DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-4248
Mailing Address - Country:US
Mailing Address - Phone:952-953-9898
Mailing Address - Fax:952-953-4466
Practice Address - Street 1:13335 PALOMINO DR
Practice Address - Street 2:SUITE 203
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-4248
Practice Address - Country:US
Practice Address - Phone:952-953-9898
Practice Address - Fax:952-953-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC04136Medicare PIN