MEDICARE: ACTIVE FAMILY CHIROPRACTIC P.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	712	ND

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5792002	OTHER	ND	BS GROUP

General Provider Information

NPI Number	:	1437361599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE FAMILY CHIROPRACTIC P.C.

Provider Business Mailing Address
First Line	:	PO BOX 26
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041
Country	:	US
Telephone Number	:	701-242-7200
Fax Number	:	701-242-7200

Provider Business Practice Location Address
First Line	:	101 1ST AVE NE
Second Line	:
City	:	HANKINSON
State	:	ND
Zip	:	58041
Country	:	US
Telephone Number	:	701-242-7200
Fax Number	:	701-242-7200

Authorized Official
Title or Position	:	PRESIDEN
Name	:	DR. TODD A SALWEY
Credential	:	D.C.
Telephone Number	:	701-242-7200

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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Directions to “ACTIVE FAMILY CHIROPRACTIC P.C. ” Practice Location

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