| Interstate Chiropractic, Llc | |
|
11276 210 St W, Ste 104, Lakeville, MN 55044 | |
| (952) 469-3443 | |
| (952) 469-3473 |
| Full Name | Interstate Chiropractic, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 11276 210 St W, Lakeville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598912818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4367 (Minnesota) | Primary |
| Provider Name | Eric Leigh Tessmer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1982743241 PECOS PAC ID: 5294706313 Enrollment ID: I20040803000875 |
| Mailing Address | Practice Location Address |
|---|---|
| Interstate Chiropractic, Llc 11276 210 St W, Ste 104, Lakeville, MN 55044 Ph: (952) 469-3443 | Interstate Chiropractic, Llc 11276 210 St W, Ste 104, Lakeville, MN 55044 Ph: (952) 469-3443 |
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