Healthcare Provider Details

I. General information

NPI: 1548408081
Provider Name (Legal Business Name): ACCESS CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 E FRANKLIN AVE SUITE 101
MINNEAPOLIS MN
55404-2974
US

IV. Provider business mailing address

1113 E FRANKLIN AVE SUITE 101
MINNEAPOLIS MN
55404-2974
US

V. Phone/Fax

Practice location:
  • Phone: 612-879-9388
  • Fax: 612-879-0005
Mailing address:
  • Phone: 612-879-9388
  • Fax: 612-879-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4511
License Number StateMN

VIII. Authorized Official

Name: DR. RASHID ALI HASSEN
Title or Position: CLINIC DIRECTOR
Credential: D.C.
Phone: 612-879-9388