Provider Demographics
NPI:1992825517
Name:SEVLIE, JOSEPH H (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
Last Name:SEVLIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 W. 3RD ST.
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066
Mailing Address - Country:US
Mailing Address - Phone:651-388-1211
Mailing Address - Fax:651-388-1311
Practice Address - Street 1:1626 W. 3RD ST.
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066
Practice Address - Country:US
Practice Address - Phone:651-388-1211
Practice Address - Fax:651-388-1311
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1966111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350001856Medicare PIN
MNT339620Medicare UPIN