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NPI Code Detail

MEDICARE: DR. CHAD F SPAULDING D.C.

MEDICARE: DR. CHAD F SPAULDING D.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
1111N00000XChiropractor3792MN

General Provider Information

NPI Number : 1821083957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAD F SPAULDING D.C.
Provider Business Mailing Address
First Line : 8170 33RD AVE S
Second Line : MS21110Q
City : MINNEAPOLIS
State : MN
Zip : 55425-4516
Country : US
Telephone Number : 952-883-5375
Fax Number : 320-203-2113
Provider Business Practice Location Address
First Line : 2251 CONNECTICUT AVENUE S
Second Line : HP CENTRAL MN CLINICS
City : SARTELL
State : MN
Zip : 56377-2486
Country : US
Telephone Number : 320-253-5220
Fax Number : 320-203-2113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 12/20/2011

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