=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477638310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARI E. AULTMAN DC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 02/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1007 NW 4TH ST STE B
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55744-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-326-0046
-----------------------------------------------------
Fax | 218-327-1543
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1007 NW 4TH ST STE B
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55744-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-326-0046
-----------------------------------------------------
Fax | 218-327-1543
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SHARI E AULTMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 218-326-0046
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2605
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------