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NPI Code Detail

MEDICARE: INNATE ABILITY CHIROPRACTIC, LLC

MEDICARE: INNATE ABILITY CHIROPRACTIC, LLC
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
1111N00000XChiropractor5128MN

General Provider Information

NPI Number : 1548582802
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNATE ABILITY CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 6520 EDENVALE BLVD
Second Line : SUITE 235
City : EDEN PRAIRIE
State : MN
Zip : 55346-2564
Country : US
Telephone Number : 952-746-5199
Fax Number : 952-937-0215
Provider Business Practice Location Address
First Line : 6520 EDENVALE BLVD
Second Line : SUITE 235
City : EDEN PRAIRIE
State : MN
Zip : 55346-2564
Country : US
Telephone Number : 952-746-5199
Fax Number : 952-937-0215
Authorized Official
Title or Position : OWNER
Name : DR. MARCIA A KRUEGER
Credential : D.C.
Telephone Number : 952-746-5199
Provider Enumeration Date : 02/26/2010
Last Update Date : 02/26/2010

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