Healthcare Provider Details

I. General information

NPI: 1053497057
Provider Name (Legal Business Name): PIERZ CHIROPRACTIC CENTER, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 S MAIN ST
PIERZ MN
56364-0276
US

IV. Provider business mailing address

PO BOX 276
PIERZ MN
56364-0276
US

V. Phone/Fax

Practice location:
  • Phone: 320-468-2561
  • Fax: 320-468-2562
Mailing address:
  • Phone: 320-468-2561
  • Fax: 320-468-2562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001745
License Number StateMN

VIII. Authorized Official

Name: MR. JOHN F. GRUNST
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 320-468-2561