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NPI Code Detail

MEDICARE: WELLS CHIROPRACTIC CLINIC INC

MEDICARE: WELLS CHIROPRACTIC CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3445MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DC5746OTHERMNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1157L4WEOTHERMNBC/BS OF MINNESOTA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063696540
Entity Type Code : Organization
Provider Name (Legal Business Name) : WELLS CHIROPRACTIC CLINIC INC
Provider Business Mailing Address
First Line : 105 N GROVE ST
Second Line :
City : BLUE EARTH
State : MN
Zip : 56013-2407
Country : US
Telephone Number : 507-526-5656
Fax Number : 507-526-5757
Provider Business Practice Location Address
First Line : 105 N GROVE ST
Second Line :
City : BLUE EARTH
State : MN
Zip : 56013-2407
Country : US
Telephone Number : 507-526-5656
Fax Number : 507-526-5757
Authorized Official
Title or Position : OWNER
Name : DR. CHAD A MALWITZ
Credential : DC
Telephone Number : 507-526-5656
Provider Enumeration Date : 12/20/2007
Last Update Date : 11/08/2022

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Directions to “WELLS CHIROPRACTIC CLINIC INC ” Practice Location

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