MEDICARE: KINETIC CHIROPRACTIC & HEALING ARTS

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	4955	MN

General Provider Information

NPI Number	:	1396998795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINETIC CHIROPRACTIC & HEALING ARTS

Provider Business Mailing Address
First Line	:	5415 NICOLLET AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55419-1927
Country	:	US
Telephone Number	:	612-824-3141
Fax Number	:	888-349-7109

Provider Business Practice Location Address
First Line	:	5415 NICOLLET AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55419-1927
Country	:	US
Telephone Number	:	612-824-3141
Fax Number	:	888-349-7109

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALEX B LANNING
Credential	:	D.C.
Telephone Number	:	612-824-3141

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	05/05/2011

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