Healthcare Provider Details

I. General information

NPI: 1831515048
Provider Name (Legal Business Name): ACCELERATRE CHIROPRACTIC & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 28TH AVE N SUITE H
SAINT CLOUD MN
56303-4588
US

IV. Provider business mailing address

44 28TH AVE N SUITE H
SAINT CLOUD MN
56303-4588
US

V. Phone/Fax

Practice location:
  • Phone: 320-774-1646
  • Fax: 877-828-6193
Mailing address:
  • Phone: 320-774-1646
  • Fax: 877-828-6193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5841
License Number StateMN

VIII. Authorized Official

Name: DR. EIRKA LEIGH YANCEY
Title or Position: CEO
Credential: DC
Phone: 320-774-1646