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General NPI Number Information
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NPI Number | 1114284064
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Entity Type | Organization
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Legal Business Name | CENTERED HEALTH CHIROPRACTIC P A
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 9920 FOLEY BLVD NW SUITE 140
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City | COON RAPIDS
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State | MN
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Zip | 55433
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Country | US
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Telephone | 763-710-5523
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Fax | 763-710-5532
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Provider Business Mailing Address
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Address Line | 9920 FOLEY BLVD NW SUITE 140
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City | COON RAPIDS
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State | MN
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Zip | 55433
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Country | US
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Telephone | 763-710-5523
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Fax | 763-710-5532
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Authorized Official
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Title or Position | OWNER CENTERED HEALTH CHIROPRACTIC
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Name | MR. DILLON ROBERT SLETTEN
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Credential | D.C
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Telephone | 763-710-5523
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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 | 5613
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License Number State | MN
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