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General NPI Number Information
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NPI Number | 1134288913
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Entity Type | Organization
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Legal Business Name | DISCOVER CHIROPRACTIC CENTER, P.C.
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6550 YORK AVE S STE 216
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City | EDINA
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State | MN
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Zip | 55435-2347
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Country | US
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Telephone | 952-746-7533
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Fax | 952-746-7536
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Provider Business Mailing Address
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Address Line | 6550 YORK AVE S STE 216
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City | EDINA
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State | MN
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Zip | 55435-2347
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Country | US
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Telephone | 952-746-7533
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Fax | 952-746-7536
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. WILLIAM THOMAS HAKE
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Credential | D.C.
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Telephone | 952-746-7533
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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 | 4583
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License Number State | MN
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