MEDICARE: DR. KARYN LYNN EKELIN D.C.

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	4760	MN
2	111N00000X	Chiropractor	4721-012	WI

General Provider Information

NPI Number	:	1356389969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARYN LYNN EKELIN D.C.

Provider Business Mailing Address
First Line	:	7265 JORDON AVE S
Second Line	:
City	:	COTTAGE GROVE
State	:	MN
Zip	:	55016-3655
Country	:	US
Telephone Number	:	651-459-7078
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 N ACRES RD
Second Line	:	SUITE A
City	:	PRESCOTT
State	:	WI
Zip	:	54021-7061
Country	:	US
Telephone Number	:	715-262-8555
Fax Number	:	715-868-8744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	02/28/2011

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