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General NPI Number Information
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NPI Number | 1952582983
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Entity Type | Organization
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Legal Business Name | MIDWEST CHIROPRACTIC PA
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 2600 DEMERS AVE STE 110
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City | GRAND FORKS
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State | ND
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Zip | 58201-4100
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Country | US
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Telephone | 701-772-3505
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Fax | 701-772-3061
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Provider Business Mailing Address
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Address Line | 2600 DEMERS AVE STE 110
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City | GRAND FORKS
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State | ND
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Zip | 58201-4100
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Country | US
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Telephone | 701-772-3505
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Fax | 701-772-3061
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Authorized Official
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Title or Position | CO-OWNER
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Name | CATHY GALSTAD
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Credential |
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Telephone | 701-772-3505
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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 | 3041
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License Number State | MN
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