Healthcare Provider Details

I. General information

NPI: 1215186846
Provider Name (Legal Business Name): PRECISION CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2518 SUPERIOR DR NW SUITE 101B
ROCHESTER MN
55901-1988
US

IV. Provider business mailing address

2518 SUPERIOR DR NW SUITE 101B
ROCHESTER MN
55901-1988
US

V. Phone/Fax

Practice location:
  • Phone: 507-287-6041
  • Fax: 507-287-6438
Mailing address:
  • Phone: 507-287-6041
  • Fax: 507-287-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number3017
License Number StateMN

VIII. Authorized Official

Name: DR. TODD MICHAEL SANDS
Title or Position: CEO
Credential: D.C.
Phone: 507-287-6041