Provider Demographics
NPI:1356701635
Name:SYNERGY CHIROPRACTIC, PA
Entity type:Organization
Organization Name:SYNERGY CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PLOESSL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-451-3311
Mailing Address - Street 1:2125 UPPER 55TH ST E STE 110
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077-1732
Mailing Address - Country:US
Mailing Address - Phone:651-451-3311
Mailing Address - Fax:651-457-4558
Practice Address - Street 1:2125 UPPER 55TH ST E
Practice Address - Street 2:SUITE 250
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55077-1734
Practice Address - Country:US
Practice Address - Phone:651-451-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty