Provider Demographics
NPI:1205907722
Name:DEAL FAMILY CHIROPRACTIC & WELLNESS CENTER, P.A.
Entity type:Organization
Organization Name:DEAL FAMILY CHIROPRACTIC & WELLNESS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-726-2091
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:LAKE CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:56055-1300
Mailing Address - Country:US
Mailing Address - Phone:507-726-2091
Mailing Address - Fax:507-726-6632
Practice Address - Street 1:201 NORTH MAIN ST.
Practice Address - Street 2:
Practice Address - City:LAKE CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:56055-1300
Practice Address - Country:US
Practice Address - Phone:507-726-2091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261 PROF FIRM111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3C199DEOtherBCBS CLINIC NUMBER
MN500228100Medicaid