MEDICARE: HELIX CHIROPRACTIC PA

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	:	1134687262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELIX CHIROPRACTIC PA

Provider Business Mailing Address
First Line	:	4719 BANNING AVE
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3217
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:	651-429-2361

Provider Business Practice Location Address
First Line	:	4719 BANNING AVE
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3217
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:	651-429-2361

Authorized Official
Title or Position	:	OWNER
Name	:	JOSHUA RICHARD JAEGER
Credential	:
Telephone Number	:	218-330-8349

Provider Enumeration Date	:	03/07/2019
Last Update Date	:	03/07/2019

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Directions to “HELIX CHIROPRACTIC PA ” Practice Location

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