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General NPI Number Information
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NPI Number | 1164922373
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Entity Type | Organization
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Legal Business Name | INVIGORATE CHIROPRACTIC, PA
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 18449 ORCHARD TRAIL
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City | LAKEVILLE
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State | MN
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Zip | 55044
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Country | US
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Telephone | 952-985-5251
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Fax | 952-595-6362
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Provider Business Mailing Address
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Address Line | 18449 ORCHARD TRAIL
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City | LAKEVILLE
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State | MN
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Zip | 55044
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN SCHULTZ
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Credential | DC
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Telephone | 952-985-5251
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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 | 6349
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License Number State | MN
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