Provider Demographics
NPI:1477388726
Name:THE HAVEN CHIROPRACTIC HEALTH CENTER PLLC
Entity type:Organization
Organization Name:THE HAVEN CHIROPRACTIC HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-GYAASE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-253-9244
Mailing Address - Street 1:643 N 5TH ST APT 332
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2753
Mailing Address - Country:US
Mailing Address - Phone:920-253-9244
Mailing Address - Fax:
Practice Address - Street 1:643 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-2692
Practice Address - Country:US
Practice Address - Phone:920-253-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty