Healthcare Provider Details

I. General information

NPI: 1194648543
Provider Name (Legal Business Name): EAGLE LAKE CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 PARKWAY AVE
EAGLE LAKE MN
56024-7709
US

IV. Provider business mailing address

PO BOX 18
EAGLE LAKE MN
56024-0018
US

V. Phone/Fax

Practice location:
  • Phone: 507-720-4194
  • Fax:
Mailing address:
  • Phone: 507-720-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRANDON SLONIKER
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 507-720-4194