Healthcare Provider Details

I. General information

NPI: 1912277195
Provider Name (Legal Business Name): APOGEE CHIROPRACTIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 CENTERVILLE CIR
VADNAIS HEIGHTS MN
55127-6344
US

IV. Provider business mailing address

1060 CENTERVILLE CIR
VADNAIS HEIGHTS MN
55127-6344
US

V. Phone/Fax

Practice location:
  • Phone: 651-429-3015
  • Fax: 651-653-3832
Mailing address:
  • Phone: 651-429-3015
  • Fax: 651-653-3832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5611
License Number StateMN

VIII. Authorized Official

Name: THOMAS JOHN POLICANO
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 651-429-3015