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General NPI Number Information
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NPI Number | 1912195124
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Entity Type | Organization
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Legal Business Name | MIDWAY CHIROPRACTIC AND HEALTH SERVICES PA
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 464 HAMLINE AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55105-2945
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Country | US
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Telephone | 651-644-7207
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Fax | 651-644-6653
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Provider Business Mailing Address
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Address Line | 464 HAMLINE AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55105-2945
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Country | US
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Telephone | 651-644-7207
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Fax | 651-644-6653
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER S LILJA
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Credential | DC
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Telephone | 651-333-0658
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | MN
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