Provider Demographics
NPI:1952347486
Name:PROECHEL, DEBRA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JEAN
Last Name:PROECHEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 3RD AVE NE
Mailing Address - Street 2:P.O. BOX 309
Mailing Address - City:FREEPORT
Mailing Address - State:MN
Mailing Address - Zip Code:56331-9017
Mailing Address - Country:US
Mailing Address - Phone:320-836-7150
Mailing Address - Fax:320-836-7162
Practice Address - Street 1:103 3RD AVE NE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:MN
Practice Address - Zip Code:56331-9017
Practice Address - Country:US
Practice Address - Phone:320-836-7150
Practice Address - Fax:320-836-7162
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2403111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN359000544Medicare ID - Type Unspecified