Healthcare Provider Details

I. General information

NPI: 1134397094
Provider Name (Legal Business Name): CUYUNA FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 W MAIN ST
CROSBY MN
56441-1421
US

IV. Provider business mailing address

5 W MAIN ST
CROSBY MN
56441-1421
US

V. Phone/Fax

Practice location:
  • Phone: 218-546-7333
  • Fax:
Mailing address:
  • Phone: 218-546-7333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3078
License Number StateMN

VIII. Authorized Official

Name: MURRAY A SMITH
Title or Position: DC
Credential:
Phone: 218-546-7333