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General NPI Number Information
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NPI Number | 1346447471
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Entity Type | Organization
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Legal Business Name | ASPENRIDGE CHIROPRACTIC CENTER P.A.
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 2511 WASHINGTON AVE
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City | CLOQUET
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State | MN
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Zip | 55720-2845
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Country | US
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Telephone | 218-879-5831
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 WASHINGTON AVE
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City | CLOQUET
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State | MN
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Zip | 55720-2845
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Country | US
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Telephone | 218-879-5831
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD MICHAEL SPILLERS
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Credential | D.C.
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Telephone | 218-879-5831
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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 | DC3901
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License Number State | MN
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