Healthcare Provider Details

I. General information

NPI: 1922925841
Provider Name (Legal Business Name): CHUECHI JACOB KONG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 RICHFIELD PKWY APT C323
RICHFIELD MN
55423-7525
US

IV. Provider business mailing address

6701 RICHFIELD PKWY APT C323
RICHFIELD MN
55423-7525
US

V. Phone/Fax

Practice location:
  • Phone: 651-207-7758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7440
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: