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General NPI Number Information
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NPI Number | 1710222088
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Entity Type | Organization
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Legal Business Name | SANTORI CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 7155 80TH STREET SO
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City | COTTAGE GROVE
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State | MN
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Zip | 55016
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Country | US
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Telephone | 651-459-5585
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Fax | 651-459-7867
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Provider Business Mailing Address
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Address Line | 7155 80TH ST S STE 110
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-3033
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Country | US
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Telephone | 651-459-5585
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Fax | 651-459-7867
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER SWANSON
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Credential |
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Telephone | 651-459-5585
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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 | MN1931
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License Number State | MN
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