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General NPI Number Information
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NPI Number | 1093043929
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Entity Type | Organization
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Legal Business Name | KRAMER CHIROPRACTIC WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 12/04/2009
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 317 1ST ST S
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City | MONTGOMERY
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State | MN
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Zip | 56069-1603
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Country | US
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Telephone | 507-364-7500
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Fax | 507-364-7444
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Provider Business Mailing Address
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Address Line | 317 1ST ST S
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City | MONTGOMERY
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State | MN
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Zip | 56069-1603
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Country | US
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Telephone | 507-364-7500
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Fax | 507-364-7444
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHANE NATE MOLITOR
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Credential | D.C.
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Telephone | 507-364-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 5204
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License Number State | MN
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