Healthcare Provider Details

I. General information

NPI: 1518175462
Provider Name (Legal Business Name): ERIC NOHNER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8451 E POINT DOUGLAS RD S
COTTAGE GROVE MN
55016-3331
US

IV. Provider business mailing address

8451 E POINT DOUGLAS RD S
COTTAGE GROVE MN
55016-3331
US

V. Phone/Fax

Practice location:
  • Phone: 651-459-3171
  • Fax: 651-768-5059
Mailing address:
  • Phone: 651-459-3171
  • Fax: 651-768-5059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4428
License Number StateMN

VIII. Authorized Official

Name: ERIC RICHARD NOHNER
Title or Position: PRESIDENT
Credential: DC
Phone: 651-459-3171