| Desired Health Chiropractic, Llc | |
|
530 W Main St Suite 10 Anoka MN 55303-2063 | |
| (612) 968-3385 | |
| Not Available |
| Full Name | Desired Health Chiropractic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 530 W Main St, Anoka, Minnesota |
| Authorized Official Name and Position | Desiree Marceline Van Bogart (CHIROPRACTOR) |
| Authorized Official Contact | 6129683385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desired Health Chiropractic, Llc 530 W Main St Suite 10 Anoka MN 55303-2063 Ph: (612) 968-3385 | Desired Health Chiropractic, Llc 530 W Main St Suite 10 Anoka MN 55303-2063 Ph: (612) 968-3385 |
| NPI Number | 1467696120 |
|---|---|
| Provider Enumeration Date | 04/26/2009 |
| Last Update Date | 04/26/2009 |
| Medicare PECOS PAC ID | 5092865055 |
|---|---|
| Medicare Enrollment ID | O20090612000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467696120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3290217-2 (Minnesota) | Primary |
| Provider Name | Desiree M Van Bogart |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457595886 PECOS PAC ID: 2466502422 Enrollment ID: I20090612000157 |
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Transformation House Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1410 S Ferry Rd, Anoka, MN 55303 Phone: 763-427-7155 Fax: 763-427-6084 |