Healthcare Provider Details

I. General information

NPI: 1588844773
Provider Name (Legal Business Name): ELDER CHIROPRACTIC OFFICES LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 01/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 MAIN ST S
CHATFIELD MN
55923-1253
US

IV. Provider business mailing address

119 MAIN ST S
CHATFIELD MN
55923-1253
US

V. Phone/Fax

Practice location:
  • Phone: 507-867-3558
  • Fax:
Mailing address:
  • Phone: 507-867-3558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number001873
License Number StateMN

VIII. Authorized Official

Name: DR. JULIE KAY ELDER
Title or Position: OWNER
Credential: D.C.
Phone: 507-867-3558