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General NPI Number Information
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NPI Number | 1003937640
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Entity Type | Individual
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Provider Name | CHAD ALAN EISWALD D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3434 LEXINGTON AVE N SUITE 900
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City | SHOREVIEW
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State | MN
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Zip | 55126-8069
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Country | US
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Telephone | 651-484-4000
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Fax | 651-486-0697
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Provider Business Mailing Address
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Address Line | 1150 BENTON WAY
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City | ARDEN HILLS
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State | MN
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Zip | 55112-3756
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Country | US
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Telephone | 651-481-0184
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Fax | 651-486-0697
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3512
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License Number State | MN
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