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General NPI Number Information
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NPI Number | 1568416584
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Entity Type | Organization
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Legal Business Name | HIGHLAND CHIROPRACTIC CENTER, P.A
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 550 SNELLING AVE S STE 203
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City | SAINT PAUL
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State | MN
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Zip | 55116-1564
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Country | US
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Telephone | 651-698-6803
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Fax | 651-698-0445
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Provider Business Mailing Address
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Address Line | 550 SNELLING AVE S STE 203
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City | SAINT PAUL
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State | MN
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Zip | 55116-1564
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Country | US
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Telephone | 651-698-9680
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Fax | 651-698-0445
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Authorized Official
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Title or Position | CEO
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Name | DR. RICHARD C. FROEHLE
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Credential | D.C.
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Telephone | 651-698-6803
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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 | 1950
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License Number State | MN
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