Provider Demographics
NPI:1649788159
Name:RESTORATION CHIROPRACTIC CHASKA, PLLC
Entity type:Organization
Organization Name:RESTORATION CHIROPRACTIC CHASKA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALGAJER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-797-3810
Mailing Address - Street 1:1107 HAZELTINE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1003
Mailing Address - Country:US
Mailing Address - Phone:952-368-4700
Mailing Address - Fax:
Practice Address - Street 1:1107 HAZELTINE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-5531
Practice Address - Country:US
Practice Address - Phone:952-368-4700
Practice Address - Fax:952-368-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4968261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center