Provider Demographics
NPI:1952509143
Name:CHIROPRACTIC CONNECTION PC
Entity Type:Organization
Organization Name:CHIROPRACTIC CONNECTION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHLEPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-363-4694
Mailing Address - Street 1:709 COUNTY ROAD 75 W
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MN
Mailing Address - Zip Code:56374-8660
Mailing Address - Country:US
Mailing Address - Phone:320-363-4694
Mailing Address - Fax:320-363-4643
Practice Address - Street 1:709 COUNTY ROAD 75 W
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-8660
Practice Address - Country:US
Practice Address - Phone:320-363-4694
Practice Address - Fax:320-363-4643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-52078OtherMEDICA
MN316P4CHOtherBCBS OF MN
MN116017OtherHEALTH PARTNERS
MN116017OtherHEALTH PARTNERS