MEDICARE: SHERBURN CHIROPRACTIC

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	4485	MN

General Provider Information

NPI Number	:	1285830422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERBURN CHIROPRACTIC

Provider Business Mailing Address
First Line	:	PO BOX 557
Second Line	:
City	:	SHERBURN
State	:	MN
Zip	:	56171-0557
Country	:	US
Telephone Number	:	507-764-4080
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 N MAIN ST
Second Line	:
City	:	SHERBURN
State	:	MN
Zip	:	56171-0557
Country	:	US
Telephone Number	:	507-764-4080
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN WAYNE LARSON
Credential	:	DC
Telephone Number	:	507-764-4080

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	08/22/2020

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Directions to “SHERBURN CHIROPRACTIC ” Practice Location

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