Provider Demographics
NPI:1750795928
Name:PAWS UP ANIMAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PAWS UP ANIMAL CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-718-5515
Mailing Address - Street 1:9308 ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-2860
Mailing Address - Country:US
Mailing Address - Phone:612-718-5515
Mailing Address - Fax:
Practice Address - Street 1:9308 ORIOLE LN
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-2860
Practice Address - Country:US
Practice Address - Phone:612-718-5515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty