Provider Demographics
NPI:1700082351
Name:HEALING HANDS FAMILY CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:HEALING HANDS FAMILY CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:ESSELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-274-0373
Mailing Address - Street 1:9125 QUADAY AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6662
Mailing Address - Country:US
Mailing Address - Phone:763-274-0373
Mailing Address - Fax:763-274-0375
Practice Address - Street 1:9125 QUADAY AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6662
Practice Address - Country:US
Practice Address - Phone:763-274-0373
Practice Address - Fax:763-274-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN002702200Medicaid
MN002702200Medicaid
MNC04159Medicare ID - Type UnspecifiedGROUP NUMBER