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General NPI Number Information
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NPI Number | 1376614081
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Entity Type | Organization
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Legal Business Name | FOR YOUR WELL BEING CHIROPRACTIC, INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2479 E. COUNTY RD. E
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110
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Country | US
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Telephone | 651-770-5433
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Fax | 651-777-1733
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Provider Business Mailing Address
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Address Line | 2479 E. COUNTY RD. E
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110
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Country | US
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Telephone | 651-770-5433
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Fax | 651-777-1733
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NANCY A. MARIHART
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Credential | D.C.
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Telephone | 651-770-5433
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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 | 4228
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License Number State | MN
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