1821074089 NPI number — RICH PRAIRIE CHIROPRACTIC, INC.

Table of content: (NPI 1821074089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821074089 NPI number — RICH PRAIRIE CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICH PRAIRIE CHIROPRACTIC, INC.
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:
Provider Other Organization Name Type Code:
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:
1821074089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
232 MAIN ST N
Provider Second Line Business Mailing Address:
PO BOX 339
Provider Business Mailing Address City Name:
PIERZ
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56364-1583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-468-2221
Provider Business Mailing Address Fax Number:
320-468-7117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PO BOX 339
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIERZ
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56364-0339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-468-2221
Provider Business Practice Location Address Fax Number:
320-468-7117
Provider Enumeration Date:
12/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JUETTEN
Authorized Official First Name:
HERBERT
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
OWNER OPERATOR DOC
Authorized Official Telephone Number:
320-468-2221

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  MN002959 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3K7060N . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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