Healthcare Provider Details

I. General information

NPI: 1629589494
Provider Name (Legal Business Name): ONE AGORA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 JAMES AVE S
BLOOMINGTON MN
55431
US

IV. Provider business mailing address

9220 JAMES AVE S
BLOOMINGTON MN
55431
US

V. Phone/Fax

Practice location:
  • Phone: 952-681-2157
  • Fax: 952-681-2280
Mailing address:
  • Phone: 952-681-2157
  • Fax: 952-681-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MEAGHAN MARIE KIRSCHLING
Title or Position: OWNER
Credential: DC APRN
Phone: 952-681-2157