1356599427 NPI number — BE WELL ADJUSTED, PC

Table of content: (NPI 1356599427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356599427 NPI number — BE WELL ADJUSTED, PC

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
BE WELL ADJUSTED, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CORNERSTONE CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356599427
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1350 20TH AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINOT
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58701-6452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-852-2800
Provider Business Mailing Address Fax Number:
701-837-0175

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1350 20TH AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINOT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-852-2800
Provider Business Practice Location Address Fax Number:
701-837-0175
Provider Enumeration Date:
09/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HANSON
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
701-852-2800

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  928 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)