Provider Demographics
NPI:1750611653
Name:CHIROPRACTIC FIRST PC
Entity type:Organization
Organization Name:CHIROPRACTIC FIRST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-298-7778
Mailing Address - Street 1:1450 25TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8105
Mailing Address - Country:US
Mailing Address - Phone:701-298-7778
Mailing Address - Fax:
Practice Address - Street 1:1450 25TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8105
Practice Address - Country:US
Practice Address - Phone:701-298-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19442Medicare UPIN