Provider Demographics
NPI:1952592552
Name:KRAMER CHIROPRACTIC P.A.
Entity Type:Organization
Organization Name:KRAMER CHIROPRACTIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-948-2804
Mailing Address - Street 1:115 W SOO ST
Mailing Address - Street 2:P.O. BOX 165
Mailing Address - City:PARKERS PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56361-4400
Mailing Address - Country:US
Mailing Address - Phone:218-338-2492
Mailing Address - Fax:218-338-2493
Practice Address - Street 1:105 MAIN ST NW
Practice Address - Street 2:BOX 206
Practice Address - City:EVANSVILLE
Practice Address - State:MN
Practice Address - Zip Code:56326-4548
Practice Address - Country:US
Practice Address - Phone:218-948-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4517261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
U99402Medicare UPIN
C03989Medicare PIN