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NPI Code Detail

MEDICARE: DR. ANNE MARIE PACKARD SPICER D.C.

MEDICARE: DR. ANNE MARIE PACKARD SPICER D.C.
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
1111N00000XChiropractor2970MN

General Provider Information

NPI Number : 1962585927
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNE MARIE PACKARD SPICER D.C.
Provider Business Mailing Address
First Line : 2501 W 84TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-1602
Country : US
Telephone Number : 952-888-4777
Fax Number : 952-886-7561
Provider Business Practice Location Address
First Line : 2501 W 84TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-1602
Country : US
Telephone Number : 952-888-4777
Fax Number : 952-886-7561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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