Provider Demographics
NPI:1134494818
Name:CARING CHIROPRACTIC CENTER, P.A.
Entity type:Organization
Organization Name:CARING CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:RUF
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:763-421-1905
Mailing Address - Street 1:10811 XAVIS ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-4037
Mailing Address - Country:US
Mailing Address - Phone:763-421-1905
Mailing Address - Fax:763-421-2517
Practice Address - Street 1:10811 XAVIS ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-4037
Practice Address - Country:US
Practice Address - Phone:763-421-1905
Practice Address - Fax:763-421-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN59598RUOtherBLUE CROSS/BLUE SHIELD
MN662028100Medicaid
MN350031612OtherRAILROAD MEDICARE
MN424152732OtherMHP
MN424152732OtherMHP