MEDICARE: DR. ALLEN HEPFNER

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	3165	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4C259FA	OTHER	MN	BCBS
2	4C260HE	OTHER	MN	BCBS

General Provider Information

NPI Number	:	1770707747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN HEPFNER

Provider Business Mailing Address
First Line	:	8800 HIGHWAY 7 STE 222
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-3927
Country	:	US
Telephone Number	:	952-938-3334
Fax Number	:

Provider Business Practice Location Address
First Line	:	8800 HIGHWAY 7 STE 222
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55426-3927
Country	:	US
Telephone Number	:	952-938-3334
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. ALLEN HEPFNER ” Practice Location

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