MEDICARE: DIRECTCARE CHIROPRACTIC, PA

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	4224	MN

General Provider Information

NPI Number	:	1740406685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECTCARE CHIROPRACTIC, PA

Provider Business Mailing Address
First Line	:	18157 CARSON CT NW STE C
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-3611
Country	:	US
Telephone Number	:	763-441-0644
Fax Number	:	763-441-4263

Provider Business Practice Location Address
First Line	:	18157 CARSON CT NW STE C
Second Line	:
City	:	ELK RIVER
State	:	MN
Zip	:	55330-3611
Country	:	US
Telephone Number	:	763-441-0644
Fax Number	:	763-441-4263

Authorized Official
Title or Position	:	OWNER
Name	:	ADAM CHARLES STUMNE
Credential	:
Telephone Number	:	763-441-0644

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	01/14/2026

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