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General NPI Number Information
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NPI Number | 1407919152
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Entity Type | Organization
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Legal Business Name | FOLEY CHIROPRACTIC OFFICE, P.A.
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Dates
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Enumeration Date | 12/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 DEWEY ST
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City | FOLEY
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State | MN
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Zip | 56329-8406
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Country | US
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Telephone | 320-969-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 401 DEWEY ST
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City | FOLEY
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State | MN
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Zip | 56329-8406
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Country | US
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Telephone | 320-969-6231
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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 L. BREWSTER
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Credential |
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Telephone | 320-968-6231
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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 | 1635
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License Number State | MN
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