Healthcare Provider Details

I. General information

NPI: 1750142360
Provider Name (Legal Business Name): MERAKI CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19201 LAKE GEORGE BLVD STE C
OAK GROVE MN
55303-8482
US

IV. Provider business mailing address

19388 ARROWHEAD ST NW
OAK GROVE MN
55011-9868
US

V. Phone/Fax

Practice location:
  • Phone: 763-200-3370
  • Fax:
Mailing address:
  • Phone: 763-218-4585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIELLE RUF
Title or Position: OWNER
Credential: DC
Phone: 763-218-4585