Organization Name: | EAGLE CREEK CHIROPRACTIC |
NPI Number: | 1073847554 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNA KANITZ (OFFICE MANAGER) |
Mailing Address: | 14180 Commerce Ave Ne Prior Lake |
State: | MN US |
Postal Code: | 553721483 |
Phone Number: | 9524473395 |
Fax Number: | 9524473396 |
NPI Enumeration Date: | 09/30/2009 |
NPI Last Update Date: | 09/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5996 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |