Healthcare Provider Details

I. General information

NPI: 1912055435
Provider Name (Legal Business Name): ANOKA CHIROPRACTIC, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 E RIVER RD SUITE 2
ANOKA MN
55303-1884
US

IV. Provider business mailing address

646 E RIVER RD SUITE 2
ANOKA MN
55303-1884
US

V. Phone/Fax

Practice location:
  • Phone: 763-421-1410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1545
License Number StateMN

VIII. Authorized Official

Name: BARNES PATRICK
Title or Position: PRESIDENT
Credential:
Phone: 763-421-1410