Provider Demographics
NPI:1396084919
Name:EGAN CHIROPRACTIC AND ACUPUNCTURE LTD
Entity type:Organization
Organization Name:EGAN CHIROPRACTIC AND ACUPUNCTURE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-590-6812
Mailing Address - Street 1:7400 LYNDALE AVE S SUITE 190 #2
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423
Mailing Address - Country:US
Mailing Address - Phone:612-590-6812
Mailing Address - Fax:
Practice Address - Street 1:7400 LYNDALE AVE S SUITE 190 #2
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423
Practice Address - Country:US
Practice Address - Phone:612-590-6812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EGAN CHIROPRACTIC AND ACUPUNCTURE LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty