NPI Code Detail JSON Logo

1740816941 NPI number — ST RAPHAELS CHIROPRACTIC CARE CENTER PLLC

NPI Number: 1740816941
Health Care Provider/Practitioner: ST RAPHAELS CHIROPRACTIC CARE CENTER PLLC

Information about “1740816941” NPI (ST RAPHAELS CHIROPRACTIC CARE CENTER PLLC) exists in 1740816941 in HTML format HTML  |  1740816941 in plain Text format TXT  |  1740816941 in PDF (Portable Document Format) PDF  |  1740816941 in an XML format XML  formats.

NPI Number : 1740816941 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740816941",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ST RAPHAELS CHIROPRACTIC CARE CENTER PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "120 CENTRAL AVE N STE C",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MILACA",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56353-1571",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "320-362-7900",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "120 CENTRAL AVE N STE C",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MILACA",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56353-1571",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "320-362-7900",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/19/2020",
    "LastUpdateDate": "06/02/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SMITH",
    "AuthorizedOfficialFirstName": "KIP",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "507-261-7202",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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