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General NPI Number Information
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NPI Number | 1609920826
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Entity Type | Organization
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Legal Business Name | FINK FAMILY CHIROPRACTIC, PA
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 18598 ELK RIVER TRL SUITE 103
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City | FARMINGTON
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State | MN
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Zip | 55024-8674
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Country | US
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Telephone | 651-428-2247
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Fax |
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Provider Business Mailing Address
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Address Line | 18556 PILOT KNOB RD SUITE 103
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City | FARMINGTON
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State | MN
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Zip | 55024-8674
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Country | US
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Telephone | 651-428-2247
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Fax | 651-463-2007
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZACHARY GILBERT LARSON
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Credential | D.C.
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Telephone | 651-428-2247
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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 | 4666
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License Number State | MN
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