Provider Demographics
NPI:1013106053
Name:URBAIN FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:URBAIN FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:URBAIN
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-876-9997
Mailing Address - Street 1:128 2ND AVE SE
Mailing Address - Street 2:PO BOX 317
Mailing Address - City:ELGIN
Mailing Address - State:MN
Mailing Address - Zip Code:55932-9732
Mailing Address - Country:US
Mailing Address - Phone:507-876-9997
Mailing Address - Fax:
Practice Address - Street 1:128 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:MN
Practice Address - Zip Code:55932-9732
Practice Address - Country:US
Practice Address - Phone:507-876-9997
Practice Address - Fax:507-876-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN153461100Medicaid
MNU81293OtherUPIN
MN153461100Medicaid