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General NPI Number Information
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NPI Number | 1538353669
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Entity Type | Organization
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Legal Business Name | EXPLORE CHIROPRACTIC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 223 3RD ST NW
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City | BEMIDJI
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State | MN
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Zip | 56601-3111
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Country | US
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Telephone | 218-333-8811
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Fax | 218-333-8813
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Provider Business Mailing Address
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Address Line | 223 3RD ST NW
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City | BEMIDJI
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State | MN
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Zip | 56601-3111
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Country | US
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Telephone | 218-333-8811
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Fax | 218-333-8813
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ANGELA JO BREMER
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Credential | D.C.
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Telephone | 218-333-8811
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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 | 4687
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License Number State | MN
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