Healthcare Provider Details

I. General information

NPI: 1922263441
Provider Name (Legal Business Name): FOCUS CHIROPRACTIC & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PROGRESS WAY
SPICER MN
56288-0053
US

IV. Provider business mailing address

180 PROGRESS WAY PO BOX 53
SPICER MN
56288
US

V. Phone/Fax

Practice location:
  • Phone: 320-796-5180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number5125
License Number StateMN

VIII. Authorized Official

Name: DR. BENJAMIN DONNER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 320-796-5180