Healthcare Provider Details

I. General information

NPI: 1528326220
Provider Name (Legal Business Name): KRISTINE ELIZABETH MICHAELS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W HOWARD ST
HIBBING MN
55746-1548
US

IV. Provider business mailing address

115 W HOWARD ST
HIBBING MN
55746-1548
US

V. Phone/Fax

Practice location:
  • Phone: 218-262-3315
  • Fax: 218-263-9648
Mailing address:
  • Phone: 218-262-3315
  • Fax: 218-263-9648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5662
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: