Essential Chiropractic SC
Organization Active NPI Chiropractor · Red Wing, MN
NPI 1013244656 · NPPES record last updated Nov 3, 2009
Key facts
- NPI
- 1013244656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ESSENTIAL CHIROPRACTIC SC
- Practice address
- 437 Main St
Red Wing, MN 55066-2324 - Phone
- (651) 388-8113
- Fax
- (651) 388-8114
- NPI assigned
- Nov 3, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Katherine M Gravesen, DC
- Title
- Vice President/Owner
- Phone
- (651) 388-8113
Practitioners 8
-
Eric Alan Starbuck, D.C.
-
Vanessa Bohr, D.C.
-
Tracie Kay Fowler, D.C.
-
Michaela Neuzil, D.C.
-
Elizabeth Agnes Olson, D.C.
-
Katherine M Gravesen, D.C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100324001057 | MN | Part B Supplier - Clinic/Group Practice | 5294861613 |
Receives reassigned benefits from 2 practitioners Practice locations: Red Wing, MN |
National Provider Directory
Locations
122 Tyler Rd S
Red Wing, MN 55066
Phone (651) 388-8113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
437 Main St
Red Wing, MN 55066-2324
Mailing address
437 Main St
Red Wing, MN 55066-2324
Phone (651) 388-8113
Other providers in Red Wing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.