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General NPI Number Information
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NPI Number | 1790031938
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Entity Type | Organization
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Legal Business Name | ELMORE FAMILY CHIROPRACTIC INC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 504 S MANTORVILLE AVE SUITE 7
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City | KASSON
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State | MN
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Zip | 55944-2206
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Country | US
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Telephone | 507-634-7288
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Fax | 507-634-7290
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Provider Business Mailing Address
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Address Line | 504 S MANTORVILLE AVE SUITE 7
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City | KASSON
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State | MN
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Zip | 55944-2206
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Country | US
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Telephone | 507-634-7288
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Fax | 507-634-7290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATIE LOUISE AUNE ELMORE
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Credential | D.C.
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Telephone | 507-721-2341
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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 | 5213
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License Number State | MN
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