| Altra Care P a | |
|
1140 Vanrooy Dr. Thief River Falls MN 56701 | |
| (218) 681-2225 | |
| (218) 681-4655 |
| Full Name | Altra Care P a |
|---|---|
| Speciality | Clinic/Center |
| Location | 1140 Vanrooy Dr., Thief River Falls, Minnesota |
| Authorized Official Name and Position | Steven Lee Keogh (OWNER) |
| Authorized Official Contact | 2186812225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Altra Care P a 1140 Vanrooy Dr. Thief River Falls MN 56701 Ph: (218) 681-2225 | Altra Care P a 1140 Vanrooy Dr. Thief River Falls MN 56701 Ph: (218) 681-2225 |
| NPI Number | 1740437789 |
|---|---|
| Provider Enumeration Date | 08/21/2008 |
| Last Update Date | 01/18/2023 |
| Certification Date | 01/18/2023 |
| Medicare PECOS PAC ID | 9133294366 |
|---|---|
| Medicare Enrollment ID | O20080821000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740437789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3608234 (Minnesota) | Primary |
| Provider Name | Steven L Keogh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1801892922 PECOS PAC ID: 5294808119 Enrollment ID: I20080724000683 |
| Provider Name | Steven Charles Keogh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518737568 PECOS PAC ID: 1951744812 Enrollment ID: I20240207002354 |
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