Provider Demographics
NPI:1801309000
Name:PARAGON CHIROPRACTIC AND WELLNESS CENTER PLLC
Entity type:Organization
Organization Name:PARAGON CHIROPRACTIC AND WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMABY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-757-1145
Mailing Address - Street 1:2860 10TH AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-2275
Mailing Address - Country:US
Mailing Address - Phone:701-757-1145
Mailing Address - Fax:
Practice Address - Street 1:2860 10TH AVE N STE 200
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2275
Practice Address - Country:US
Practice Address - Phone:701-757-1145
Practice Address - Fax:701-757-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty