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NPI Code Detail

MEDICARE: WAXBERG CLINIC PA

MEDICARE: WAXBERG CLINIC PA
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
1111N00000XChiropractor3686MN

General Provider Information

NPI Number : 1881873511
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAXBERG CLINIC PA
Provider Business Mailing Address
First Line : 805 MAIN ST S
Second Line :
City : PINE CITY
State : MN
Zip : 55063-1660
Country : US
Telephone Number : 320-629-5288
Fax Number : 320-629-5289
Provider Business Practice Location Address
First Line : 805 MAIN ST S
Second Line :
City : PINE CITY
State : MN
Zip : 55063-1660
Country : US
Telephone Number : 320-629-5288
Fax Number : 320-629-5289
Authorized Official
Title or Position : OWNER
Name : DR. RACHEL E WAXBERG
Credential : DC
Telephone Number : 320-629-5288
Provider Enumeration Date : 10/30/2007
Last Update Date : 09/25/2012

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Directions to “WAXBERG CLINIC PA ” Practice Location

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