MEDICARE: KNAFLA CHIROPRACTIC CLINIC, LTD

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	111NS0005X	Sports Physician Chiropractor	3105	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	350045207	OTHER		PALMETTO GBA RAILROAD
3	44-40199	OTHER	MN	MEDICA
4	4C215-KN	OTHER	MN	BLUE CROSS BLUE SHIELD OF MN GRP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	CC00463	OTHER	MN	CC/LANDMARK
7	4C216-KN	OTHER	MN	BLUE CROSS BLUE SHIELD OF MN

General Provider Information

NPI Number	:	1720167117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNAFLA CHIROPRACTIC CLINIC, LTD

Provider Business Mailing Address
First Line	:	900 S RUM RIVER DR STE 102
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-2239
Country	:	US
Telephone Number	:	763-389-5803
Fax Number	:	763-389-0063

Provider Business Practice Location Address
First Line	:	900 S RUM RIVER DR STE 102
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-2239
Country	:	US
Telephone Number	:	763-389-5803
Fax Number	:	763-389-0063

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATHRYN MARIE KNAFLA
Credential	:	DC, CCSP
Telephone Number	:	763-389-5803

Provider Enumeration Date	:	11/04/2006
Last Update Date	:	04/15/2025

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Practice Location Address:

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1881682680 — ELIM HOMES, INC.
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1689665705 — RONALD HUEBSCH OD
Practice Location Address:

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1922085299 — FAIRVIEW HEALTH SERVICES
Practice Location Address:

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Directions to “KNAFLA CHIROPRACTIC CLINIC, LTD ” Practice Location

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