Healthcare Provider Details

I. General information

NPI: 1619007010
Provider Name (Legal Business Name): PAUL MICHAEL MAKI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 GRANT AVENUE
EVELETH MN
55734
US

IV. Provider business mailing address

227 GRANT AVENUE
EVELETH MN
55734
US

V. Phone/Fax

Practice location:
  • Phone: 218-744-1910
  • Fax: 218-744-5397
Mailing address:
  • Phone: 218-744-1910
  • Fax: 218-744-5397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3574
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: