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General NPI Number Information
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NPI Number | 1437943677
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Entity Type | Organization
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Legal Business Name | NORTH BRANCH FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 6241 MAIN ST STE 102
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City | NORTH BRANCH
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State | MN
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Zip | 55056-5139
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Country | US
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Telephone | 651-470-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 30026 VASSAR ST NE
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City | NORTH BRANCH
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State | MN
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Zip | 55056-6573
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Country | US
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Telephone | 651-470-7157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAYLENE MYA HUTCHINGS
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Credential | DC
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Telephone | 651-470-5422
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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 |
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License Number State |
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