Provider Demographics
NPI:1447879515
Name:NODAK CHIROPRACTIC AND ACUPUNCTURE LLC
Entity type:Organization
Organization Name:NODAK CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAKOTA
Authorized Official - Middle Name:ALLEN LEO
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-214-7703
Mailing Address - Street 1:2730 PAINTBALL WAY BLDG B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-2503
Mailing Address - Country:US
Mailing Address - Phone:701-214-7703
Mailing Address - Fax:
Practice Address - Street 1:2730 PAINTBALL WAY BLDG B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ND
Practice Address - Zip Code:58504-2503
Practice Address - Country:US
Practice Address - Phone:701-214-7703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty