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General NPI Number Information
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NPI Number | 1457470445
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Entity Type | Organization
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Legal Business Name | POESCHEL CHIROPRACTIC PSC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 1818 WOODDALE DR STE #100
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City | WOODBURY
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State | MN
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Zip | 55125-2983
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Country | US
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Telephone | 651-756-7380
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Fax | 651-340-9765
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Provider Business Mailing Address
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Address Line | 1818 WOODDALE DR STE #100
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City | WOODBURY
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State | MN
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Zip | 55125-2983
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Country | US
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Telephone | 651-756-7380
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Fax | 651-340-9765
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT WILLIAM POESCHEL
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Credential | D.C.
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Telephone | 651-756-7380
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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 | 3949
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License Number State | MN
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