Provider Demographics
NPI:1871764787
Name:CHIROCENTER-BLOOMINGTON PA
Entity type:Organization
Organization Name:CHIROCENTER-BLOOMINGTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-884-1850
Mailing Address - Street 1:8120 PENN AVE S STE 525
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1312
Mailing Address - Country:US
Mailing Address - Phone:952-884-1850
Mailing Address - Fax:952-884-3925
Practice Address - Street 1:PENN AVE S
Practice Address - Street 2:SUITE 525
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1312
Practice Address - Country:US
Practice Address - Phone:952-884-1850
Practice Address - Fax:952-884-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty