=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841839156
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARADOX CHIROPRACTIC PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2020
-----------------------------------------------------
Last Update Date | 01/03/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16541 HAVEN RD
-----------------------------------------------------
City | LITTLE FALLS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56345-6401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-632-6757
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 562
-----------------------------------------------------
City | LITTLE FALLS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56345-0562
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-632-6757
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. DEANN LYNN ADAMS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 320-632-6757
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------