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General NPI Number Information
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NPI Number | 1558765792
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Entity Type | Organization
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Legal Business Name | AURORA CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 1051 MADISON AVE
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City | MANKATO
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State | MN
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Zip | 56001-6143
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Country | US
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Telephone | 507-508-5066
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Fax |
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Provider Business Mailing Address
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Address Line | 1051 MADISON AVE STE 2
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City | MANKATO
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State | MN
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Zip | 56001-6143
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Country | US
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Telephone | 507-625-1085
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Fax | 507-625-6305
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LYNN STUVEK
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Credential | D.C.
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Telephone | 507-508-5066
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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 | 5980
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License Number State | MN
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