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General NPI Number Information
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NPI Number | 1639538051
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Entity Type | Organization
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Legal Business Name | WEST CENTRAL CHIROPRACTIC & WELLNESS, LLC
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 123 3RD AVE. E SUITE 100
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City | ALEXANDRIA
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State | MN
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Zip | 56308
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Country | US
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Telephone | 320-762-0683
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Fax | 320-762-1278
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Provider Business Mailing Address
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Address Line | PO BOX 611
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City | ALEXANDRIA
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State | MN
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Zip | 56308
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Country | US
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Telephone | 320-762-0683
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Fax | 320-762-1278
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Authorized Official
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Title or Position | OWNER
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Name | ZACHARY JAMES MAAS
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Credential | DC
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Telephone | 218-371-1156
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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 | 6175
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License Number State | MN
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