MEDICARE: OPP FAMILY CHIROPRACTIC P.A.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982890810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPP FAMILY CHIROPRACTIC P.A.

Provider Business Mailing Address
First Line	:	23168 SAINT FRANCIS BLVD NW
Second Line	:	#600
City	:	SAINT FRANCIS
State	:	MN
Zip	:	55070-9805
Country	:	US
Telephone Number	:	763-213-0615
Fax Number	:	763-213-0616

Provider Business Practice Location Address
First Line	:	23168 SAINT FRANCIS BLVD NW
Second Line	:	#600
City	:	SAINT FRANCIS
State	:	MN
Zip	:	55070-9805
Country	:	US
Telephone Number	:	763-213-0615
Fax Number	:	763-213-0616

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRIAN JEREMY OPP
Credential	:	D.C.
Telephone Number	:	763-213-0615

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	05/07/2024

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Directions to “OPP FAMILY CHIROPRACTIC P.A. ” Practice Location

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