MEDICARE: DR. CHUECHI JACOB KONG DC

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	7440	MN

General Provider Information

NPI Number	:	1922925841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHUECHI JACOB KONG DC

Provider Business Mailing Address
First Line	:	6701 RICHFIELD PKWY APT C323
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-7525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 RICHFIELD PKWY APT C323
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-7525
Country	:	US
Telephone Number	:	651-207-7758
Fax Number	:

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

Provider Enumeration Date	:	07/01/2026
Last Update Date	:	07/01/2026

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