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General NPI Number Information
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NPI Number | 1124349253
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Entity Type | Organization
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Legal Business Name | WASECA FAMILY CHIROPRACTIC CLINIC INC.
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 117 STATE ST N
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City | WASECA
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State | MN
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Zip | 56093-2928
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Country | US
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Telephone | 507-835-7660
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Fax | 507-835-7691
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Provider Business Mailing Address
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Address Line | 117 STATE ST N
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City | WASECA
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State | MN
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Zip | 56093-2928
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Country | US
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Telephone | 507-835-7660
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Fax | 507-835-7691
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | ROBERT PAUL DASCHNER
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Credential | D.C.
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Telephone | 507-835-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3328
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License Number State | MN
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