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General NPI Number Information
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NPI Number | 1710007620
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Entity Type | Organization
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Legal Business Name | PAPPENFUS CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10824 STANLEY AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55437-3333
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Country | US
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Telephone | 651-699-4169
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 385523-5523
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City | BLOOMINGTON
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State | MN
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Zip | 55438-5523
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Country | US
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Telephone | 651-699-4169
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK RICHARD PAPPENFUS
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Credential | DC
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Telephone | 651-699-4169
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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 | 2508
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License Number State | MN
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