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NPI Code Detail

MEDICARE: NORTHEAST CHIROPRACTIC PLLC

MEDICARE: NORTHEAST CHIROPRACTIC PLLC
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
1111N00000XChiropractor

General Provider Information

NPI Number : 1205370285
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST CHIROPRACTIC PLLC
Provider Business Mailing Address
First Line : 34 13TH AVE NE STE 109
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1007
Country : US
Telephone Number : 612-378-1050
Fax Number : 612-378-1051
Provider Business Practice Location Address
First Line : 34 13TH AVE NE STE 109
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1007
Country : US
Telephone Number : 612-378-1050
Fax Number : 612-378-1051
Authorized Official
Title or Position : OWNER
Name : DR. TRAVIS MYRON SHERMER
Credential : DC
Telephone Number : 651-394-2280
Provider Enumeration Date : 12/12/2016
Last Update Date : 02/06/2026

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Directions to “NORTHEAST CHIROPRACTIC PLLC ” Practice Location

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