| St Raphaels Chiropractic Care Center Pllc | |
|
120 Central Ave N Ste C, Milaca, MN 56353-1571 | |
| (320) 362-7900 | |
| Not Available |
| Full Name | St Raphaels Chiropractic Care Center Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 120 Central Ave N Ste C, Milaca, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740816941 | NPI | - | NPPES |
| 170123100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Kip A Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497854392 PECOS PAC ID: 2567365232 Enrollment ID: I20170526000053 |
| Provider Name | Kip A Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1497854392 PECOS PAC ID: 2567365232 Enrollment ID: I20190621001982 |
| Mailing Address | Practice Location Address |
|---|---|
| St Raphaels Chiropractic Care Center Pllc 120 Central Ave N Ste C, Milaca, MN 56353-1571 Ph: (320) 362-7900 | St Raphaels Chiropractic Care Center Pllc 120 Central Ave N Ste C, Milaca, MN 56353-1571 Ph: (320) 362-7900 |
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