| Moua-lor Chiropractic And Acupuncture, Pa | |
|
5600 Bass Lake Rd Ste D Crystal MN 55429-2722 | |
| (612) 529-0202 | |
| (612) 521-1445 |
| Full Name | Moua-lor Chiropractic And Acupuncture, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 5600 Bass Lake Rd Ste D, Crystal, Minnesota |
| Authorized Official Name and Position | Yer Moua-lor (PRESIDENT/OWNER) |
| Authorized Official Contact | 6125290202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moua-lor Chiropractic And Acupuncture, Pa 5600 Bass Lake Rd Ste D Crystal MN 55429-2722 Ph: (612) 529-0202 | Moua-lor Chiropractic And Acupuncture, Pa 5600 Bass Lake Rd Ste D Crystal MN 55429-2722 Ph: (612) 529-0202 |
| NPI Number | 1871851329 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 4284897737 |
|---|---|
| Medicare Enrollment ID | O20120518000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871851329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4013 (Minnesota) | Primary |
| Provider Name | Yer Moua-lor |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548355142 PECOS PAC ID: 6002079555 Enrollment ID: I20120518000601 |
| Provider Name | Alex Jolly |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205224243 PECOS PAC ID: 5890012231 Enrollment ID: I20150324002694 |
| Provider Name | Gabriel Kimball |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881387017 PECOS PAC ID: 1759742042 Enrollment ID: I20230802004174 |
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