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General NPI Number Information
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NPI Number | 1477709814
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Entity Type | Organization
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Legal Business Name | NORTHLAND CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1940 GREELEY ST S # 112
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City | STILLWATER
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State | MN
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Zip | 55082-5097
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Country | US
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Telephone | 651-430-2727
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Fax | 651-342-0815
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Provider Business Mailing Address
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Address Line | 1940 GREELEY ST S # 112
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City | STILLWATER
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State | MN
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Zip | 55082-5097
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Country | US
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Telephone | 651-430-2727
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Fax | 651-342-0815
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. COREY MICHAEL OSCARSON
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Credential | DC
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Telephone | 651-430-2727
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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 | 4122
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License Number State | MN
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