Healthcare Provider Details

I. General information

NPI: 1518037100
Provider Name (Legal Business Name): CENTER FOR ALTERNATIVE HEALTH AND CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 10TH AVE S
HOPKINS MN
55343-7505
US

IV. Provider business mailing address

17 10TH AVE S
HOPKINS MN
55343-7505
US

V. Phone/Fax

Practice location:
  • Phone: 952-541-5669
  • Fax: 952-927-0178
Mailing address:
  • Phone: 952-541-5669
  • Fax: 952-927-0178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2285
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2285
License Number StateMN

VIII. Authorized Official

Name: DR. PAUL STEPHEN NASH
Title or Position: OWNER
Credential: D.C.
Phone: 952-541-5669