| Lifespan Chiropractic Pa | |
|
7493 147th St W Suite 203 Apple Valley MN 55124-4505 | |
| (952) 432-4222 | |
| (952) 432-4225 |
| Full Name | Lifespan Chiropractic Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 7493 147th St W, Apple Valley, Minnesota |
| Authorized Official Name and Position | Katy Jean Heilman (PRESIDENT) |
| Authorized Official Contact | 9524324222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Chiropractic Pa 7493 147th St W Suite 203 Apple Valley MN 55124-4505 Ph: (952) 432-4222 | Lifespan Chiropractic Pa 7493 147th St W Suite 203 Apple Valley MN 55124-4505 Ph: (952) 432-4222 |
| NPI Number | 1770864431 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 09/07/2011 |
| Medicare PECOS PAC ID | 0941473268 |
|---|---|
| Medicare Enrollment ID | O20111102000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770864431 | NPI | - | NPPES |
| 7815204-00 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3437 (Minnesota) | Primary |
| Provider Name | Katy J Heilman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942427059 PECOS PAC ID: 3678746997 Enrollment ID: I20111102000531 |
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