Healthcare Provider Details

I. General information

NPI: 1508984105
Provider Name (Legal Business Name): PATHWAYS CHIROPRACTIC HEALTH CENTER OF SAVAGE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14233 OCONNELL CT STE 500
SAVAGE MN
55378-2860
US

IV. Provider business mailing address

14233 OCONNELL CT STE 500
SAVAGE MN
55378-2860
US

V. Phone/Fax

Practice location:
  • Phone: 952-226-5502
  • Fax: 952-226-5504
Mailing address:
  • Phone: 952-226-5502
  • Fax: 952-226-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3613
License Number StateMN

VIII. Authorized Official

Name: MR. KENNETH RANDALL BARNETT
Title or Position: DOCTOR/OWNER
Credential: D.C.
Phone: 952-226-5502