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NPI Code Detail

MEDICARE: P & J HOLDINGS, INC

MEDICARE: P & J HOLDINGS, INC
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
1111N00000XChiropractor003565MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
202B34RIOTHERMNBLUE CROSS BLUE SHIELD OF MN

General Provider Information

NPI Number : 1982794129
Entity Type Code : Organization
Provider Name (Legal Business Name) : P & J HOLDINGS, INC
Provider Business Mailing Address
First Line : 314 MAIN ST E
Second Line : SUITE 2
City : NEW PRAGUE
State : MN
Zip : 56071-2448
Country : US
Telephone Number : 952-758-4739
Fax Number : 952-758-8047
Provider Business Practice Location Address
First Line : 314 MAIN ST E
Second Line : SUITE 2
City : NEW PRAGUE
State : MN
Zip : 56071-2448
Country : US
Telephone Number : 952-758-4739
Fax Number : 952-758-8047
Authorized Official
Title or Position : CEO
Name : DR. JOEL GARY ERICKSON
Credential : DC
Telephone Number : 952-758-4739
Provider Enumeration Date : 10/16/2006
Last Update Date : 07/17/2008

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Directions to “P & J HOLDINGS, INC ” Practice Location

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