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General NPI Number Information
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NPI Number | 1194832550
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Entity Type | Organization
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Legal Business Name | KINNI VALLEY CHIROPRACTIC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 N 2ND ST SUITE 201
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City | RIVER FALLS
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State | WI
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Zip | 54022-3706
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Country | US
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Telephone | 715-425-6665
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Fax | 715-425-6677
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Provider Business Mailing Address
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Address Line | 215 N 2ND ST SUITE 201
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City | RIVER FALLS
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State | WI
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Zip | 54022-3706
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Country | US
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Telephone | 715-425-6665
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Fax | 715-425-6677
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN JAMES SENORASKE
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Credential | D.C.
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Telephone | 715-425-6665
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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 | 3731012
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License Number State | WI
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