Organization Name: | WELLSPRING SPINAL CARE, PC |
NPI Number: | 1336512920 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERIC JAMES ORTMAN (CEO) |
Mailing Address: | 540 Greenhaven Rd Suite 204 Anoka |
State: | MN US |
Postal Code: | 553031674 |
Phone Number: | 9523039124 |
Fax Number: | |
NPI Enumeration Date: | 11/05/2015 |
NPI Last Update Date: | 11/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 5746 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |