Provider Demographics
NPI:1336174267
Name:FINK, JAMES JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOHN
Last Name:FINK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55921-4506
Mailing Address - Country:US
Mailing Address - Phone:507-725-8913
Mailing Address - Fax:
Practice Address - Street 1:103 N. RAMSEY
Practice Address - Street 2:SUITE 3
Practice Address - City:CALEDONIA
Practice Address - State:MN
Practice Address - Zip Code:55921
Practice Address - Country:US
Practice Address - Phone:507-725-7777
Practice Address - Fax:507-725-8867
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4832111N00000X
WI3339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU62103Medicare UPIN
MN38895600Medicare ID - Type Unspecified
WI70588Medicare ID - Type Unspecified