MEDICARE: TRUE NORTH CHIROPRACTIC CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1073991170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE NORTH CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	1238 EDGEWOOD DR APT 6
Second Line	:
City	:	THIEF RIVER FALLS
State	:	MN
Zip	:	56701-3323
Country	:	US
Telephone Number	:	701-739-2968
Fax Number	:

Provider Business Practice Location Address
First Line	:	1238 EDGEWOOD DR APT 6
Second Line	:
City	:	THIEF RIVER FALLS
State	:	MN
Zip	:	56701-3323
Country	:	US
Telephone Number	:	701-739-2968
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	NATHAN WEISS
Credential	:	DC
Telephone Number	:	701-739-2968

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/11/2015

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