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General NPI Number Information
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NPI Number | 1548639586
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Entity Type | Organization
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Legal Business Name | PERFECT TOUCH MASSAGE & CHIROPRACTIC, LTD
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Dates
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Enumeration Date | 09/21/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 3101 OLD HIGHWAY 8 SUITE 300
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City | ROSEVILLE
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State | MN
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Zip | 55113-1072
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Country | US
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Telephone | 763-746-3344
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Fax |
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Provider Business Mailing Address
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Address Line | 377 JAY WAY
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City | VADNAIS HEIGHTS
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State | MN
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Zip | 55127-7953
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Country | US
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Telephone | 763-746-3344
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Fax |
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Authorized Official
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Title or Position | CEO, CHIROPRACTOR
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Name | DR. NICOLE ROSE KLERSY-MOHR
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Credential | D.C., C.M.T.
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Telephone | 763-746-3344
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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 | 6117
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 6117
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License Number State | MN
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