MEDICARE: ERIC J. WESSELS CHIROPRACTIC, PLLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1548843097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC J. WESSELS CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	2915 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2145
Country	:	US
Telephone Number	:	612-242-2600
Fax Number	:	612-341-9079

Provider Business Practice Location Address
First Line	:	2915 WAYZATA BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2145
Country	:	US
Telephone Number	:	612-242-2600
Fax Number	:	612-341-9079

Authorized Official
Title or Position	:	OWNER /PROVIDER
Name	:	DR. ERIC JAMES WESSELS
Credential	:	DC
Telephone Number	:	612-242-2600

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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