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General NPI Number Information
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NPI Number | 1437233814
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Entity Type | Organization
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Legal Business Name | HOMECARE CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 3636 OAK CREEK TER
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-7034
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Country | US
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Telephone | 612-331-9999
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Fax | 612-331-9990
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Provider Business Mailing Address
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Address Line | 3636 OAK CREEK TER
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-7034
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Country | US
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Telephone | 612-331-9999
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Fax | 612-331-9990
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Authorized Official
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Title or Position | OFFICER
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Name | DR. ROBERT JOSEPH STAEHELI
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Credential | D.C.
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Telephone | 612-331-9999
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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 | 292
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License Number State | MN
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