Tonderum Family Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

TONDERUM FAMILY CHIROPRACTIC PLLC

Doing business as

Legacy Family Chiropractic

Practice address

171 7TH Ave S
Waite Park, MN 56387-1362

Phone

(320) 744-1013

NPI assigned

Sep 17, 2018

Last updated

Oct 3, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tyler Tonderum, DCNPI 1487135422

Title

President

Phone

(712) 209-2597

Specialties & licenses 1

Addresses

Other names 1

• Legacy Family Chiropractic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler Tonderum, DC

  • Chiropractor
  • Armstrong, IA
  • NPI 1487135422
  Authorized official Same address or phone
• Evan Eigen, D.C.

  • Chiropractor
  • Waite Park, MN
  • NPI 1851648604
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1003390063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 10TH AVE S",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871055",
            "telephone_number": "320-774-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 7TH AVE S",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871362",
            "telephone_number": "320-744-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONDERUM FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "TONDERUM",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-209-2597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legacy Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Waite Park, MN
• Providers in Waite Park, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.