Provider Demographics
NPI:1003106048
Name:OAK HILL CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:OAK HILL CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DEPAULIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-283-9641
Mailing Address - Street 1:12 LONG LAKE RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:MAHTOMEDI
Mailing Address - State:MN
Mailing Address - Zip Code:55115-6814
Mailing Address - Country:US
Mailing Address - Phone:651-283-9641
Mailing Address - Fax:
Practice Address - Street 1:12 LONG LAKE RD
Practice Address - Street 2:SUITE 19
Practice Address - City:MAHTOMEDI
Practice Address - State:MN
Practice Address - Zip Code:55115-6814
Practice Address - Country:US
Practice Address - Phone:651-283-9641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3150111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty