Functional Chiropractic Rehab, Pllc | |
1901 Madison Ave Ste 120 Mankato MN 56001-6267 | |
(605) 380-4364 | |
Not Available |
Full Name | Functional Chiropractic Rehab, Pllc |
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Speciality | Clinic/center |
Location | 1901 Madison Ave Ste 120, Mankato, Minnesota |
Authorized Official Name and Position | Benjamin Martin Hansen (OWNER) |
Authorized Official Contact | 6053804364 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Functional Chiropractic Rehab, Pllc 1901 Madison Ave Ste 120 Mankato MN 56001-6267 Ph: (605) 380-4364 | Functional Chiropractic Rehab, Pllc 1901 Madison Ave Ste 120 Mankato MN 56001-6267 Ph: (605) 380-4364 |
NPI Number | 1073149779 |
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Provider Enumeration Date | 03/14/2020 |
Last Update Date | 04/01/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073149779 | NPI | - | NPPES |
1326676412 | Other | MN | NATIONAL PROVIDER IDENTIFIER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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