MEDICARE: CANNON VALLEY CHIROPRACTIC,LLC

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	111NS0005X	Sports Physician Chiropractor	4074	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01N79CA	OTHER	MN	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1194809863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANNON VALLEY CHIROPRACTIC,LLC

Provider Business Mailing Address
First Line	:	6505 CEDAR HILLS DR
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-4253
Country	:	US
Telephone Number	:	507-263-3925
Fax Number	:	507-263-5065

Provider Business Practice Location Address
First Line	:	6505 CEDAR HILLS DR
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-4253
Country	:	US
Telephone Number	:	507-263-3925
Fax Number	:	507-263-5065

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. MATTHEW AUGUST MAKI
Credential	:	D.C.
Telephone Number	:	507-263-3925

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1215011044 — DR. MATTHEW AUGUST MAKI D.C.
Practice Location Address:

6505 CEDAR HILLS DR
CANNON FALLS, MN
55009-4253

Practice Phone: 507-263-3925
Practice Fax: 507-263-5065

1558368233 — WESTERN VISITING NURSES, INC.
Practice Location Address:

1400 BENTON ST
IDAHO FALLS, ID
83401-4253

Practice Phone: 208-522-3291
Practice Fax: 208-529-3914

1427013234 — MR. KENNETH E. SCHIELDS ATC/LAT
Practice Location Address:

8111 STIRLING FALLS CIR
SARASOTA, FL
34243-4253

Practice Phone: 941-351-7086
Practice Fax:

1841290921 — CANNON FALLS SNYDER PHCY INC
Practice Location Address:

31265 COUNTY 24 BLVD
CANNON FALLS, MN
55009-4071

Practice Phone: 507-263-4741
Practice Fax: 507-263-0740

1356343230 — DR. DANIEL CURTIS CALLSTROM D.D.S.
Practice Location Address:

114 3RD ST N
CANNON FALLS, MN
55009-2011

Practice Phone: 507-263-4501
Practice Fax: 507-263-5691

Directions to “CANNON VALLEY CHIROPRACTIC,LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.