Provider Demographics
NPI:1942303912
Name:MINNESOTA HEALTH AND WELLNESS CLINICS INC.
Entity Type:Organization
Organization Name:MINNESOTA HEALTH AND WELLNESS CLINICS INC.
Other - Org Name:NAVARRO CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.C.A.
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-332-0202
Mailing Address - Street 1:328 HERITAGE PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5251
Mailing Address - Country:US
Mailing Address - Phone:507-332-0202
Mailing Address - Fax:507-332-2206
Practice Address - Street 1:328 HERITAGE PL
Practice Address - Street 2:SUITE A
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5251
Practice Address - Country:US
Practice Address - Phone:507-332-0202
Practice Address - Fax:507-332-2206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03072Medicare PIN