Healthcare Provider Details

I. General information

NPI: 1134296486
Provider Name (Legal Business Name): APEX CHIROPRACTIC OF ALBERTVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5676 LA CENTRE AVE SUITE 202
ALBERTVILLE MN
55301-4022
US

IV. Provider business mailing address

PO BOX 158
CHAMPLIN MN
55316-0158
US

V. Phone/Fax

Practice location:
  • Phone: 763-497-0777
  • Fax:
Mailing address:
  • Phone: 763-533-2742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3596
License Number StateMN

VIII. Authorized Official

Name: DR. RICHARD PAUL WILLIAMS
Title or Position: OWNER
Credential: D.C.
Phone: 763-533-0654