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General NPI Number Information
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NPI Number | 1750436598
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Entity Type | Organization
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Legal Business Name | DODGE CENTER CHIROPRACTIC OFFICE, P.A.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 2ND AVE NW
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City | DODGE CENTER
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State | MN
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Zip | 55927
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Country | US
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Telephone | 507-374-6742
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 298
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City | DODGE CENTER
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State | MN
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Zip | 55927-0298
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Country | US
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Telephone | 507-374-6742
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW THOMAS KLEIN
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Credential | D.C.
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Telephone | 507-374-6742
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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 | 4748
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License Number State | MN
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