GREEN LAKE CHIROPRACTIC PA NPI 1760660427

NPI Information

NPI: 1760660427
Provider Name: GREEN LAKE CHIROPRACTIC, PA

Doing Business As: MERIDIAN DISC INSTITUTE

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
205 5TH ST SW
WILLMAR, MN
ZIP 56201
Phone: (320) 214-0044
Get Directions

GREEN LAKE CHIROPRACTIC, PA is a health service clinic center in Willmar, MN. GREEN LAKE CHIROPRACTIC, PA NPI is 1760660427. The provider is registered as an organization entity type.
The provider Is Doing Business As Meridian Disc Institute.

The provider's business location address is:

205 5TH ST SW
WILLMAR, MN
ZIP 56201-211
Phone: (320) 214-0044
Fax: (320) 214-0045

The provider's authorized official is Jon D. Haefner .
The authorized official title is President and has the following contact phone number (320) 214-0044.

The enumeration date for this NPI number is 2/5/2008 and was last updated on 6/2/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	4176	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0868	OTHER	MINNESOTA	HEALTH SERVICE MGMT.
2	062M1GR	OTHER	MINNESOTA	MN BCBS
3	627686	OTHER	MINNESOTA	ACN GROUP
4	C04837	MEDICARE PIN	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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