Provider Demographics
NPI:1023458577
Name:DISCOVER CHIROPRACTIC
Entity type:Organization
Organization Name:DISCOVER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBENDRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-232-2789
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:NICOLLET
Mailing Address - State:MN
Mailing Address - Zip Code:56074-0388
Mailing Address - Country:US
Mailing Address - Phone:507-232-2789
Mailing Address - Fax:
Practice Address - Street 1:304 PINE ST
Practice Address - Street 2:
Practice Address - City:NICOLLET
Practice Address - State:MN
Practice Address - Zip Code:56074-2077
Practice Address - Country:US
Practice Address - Phone:507-232-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty