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General NPI Number Information
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NPI Number | 1255763603
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Entity Type | Organization
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Legal Business Name | PEREZ CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 08/07/2013
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Provider Practice Location Address
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Address Line | 6519 NICOLLET AVE SUITE 300
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City | RICHFIELD
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State | MN
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Zip | 55423-1669
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Country | US
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Telephone | 612-200-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 6519 NICOLLET AVE SUITE 300
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City | RICHFIELD
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State | MN
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Zip | 55423-1669
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Country | US
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Telephone | 612-200-9993
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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. JOSEY PEREZ
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Credential | D.C.
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Telephone | 612-746-5557
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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 | 4101
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License Number State | MN
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