Healthcare Provider Details
I. General information
NPI: 1114028503
Provider Name (Legal Business Name): MED-PLUS HEALTH CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2921 S FRONTAGE RD STE 3
MOORHEAD MN
56560-2571
US
IV. Provider business mailing address
2921 S FRONTAGE RD STE 3
MOORHEAD MN
56560-2571
US
V. Phone/Fax
- Phone: 218-233-8544
- Fax: 218-233-8545
- Phone: 218-233-8544
- Fax: 218-233-8545
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1896 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 6503 |
| License Number State | MN |
VIII. Authorized Official
Name:
JACE
FOSS
Title or Position: CHIEF MANAGER/OWNER
Credential: DC
Phone: 218-233-8544