Healthcare Provider Details

I. General information

NPI: 1427124874
Provider Name (Legal Business Name): APEX CHIROPRACTIC D.C., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 WINNETKA AVE N
NEW HOPE MN
55428-4924
US

IV. Provider business mailing address

4221 WINNETKA AVE N
NEW HOPE MN
55428-4924
US

V. Phone/Fax

Practice location:
  • Phone: 763-533-0654
  • Fax: 763-537-5305
Mailing address:
  • Phone: 763-533-0654
  • Fax: 763-537-5305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5615
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3963
License Number StateMN

VIII. Authorized Official

Name: DR. STEVEN LAWRENCE HUBERTY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 763-533-0654