Healthcare Provider Details

I. General information

NPI: 1891857959
Provider Name (Legal Business Name): HEALTHFIRST CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2594 TILDEN TRL SW
PINE RIVER MN
56474-4041
US

IV. Provider business mailing address

PO BOX 487
PINE RIVER MN
56474-0487
US

V. Phone/Fax

Practice location:
  • Phone: 218-587-4681
  • Fax: 218-587-4290
Mailing address:
  • Phone: 218-587-4681
  • Fax: 218-587-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RONALD LEE PROUTY
Title or Position: OWNER
Credential: D.C.
Phone: 218-587-4681