Peter Lee Kelzenberg, D.C.
Individual provider Active NPI Radiology Chiropractor · Osseo, MN
NPI 1043483084 · NPPES record last updated Apr 10, 2008
Key facts
- NPI
- 1043483084
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiology Chiropractor 111NR0200X
- License
- 3440 (MN)
- Practice address
- 220 Central Avenue
Osseo, MN 55369 - Phone
- (763) 425-5525
- Fax
- (763) 425-6229
- NPI assigned
- Apr 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3440 | MN | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Chiropractor | 111NR0200X | 3440 | MN | Yes |
Addresses
Primary practice location
220 Central Avenue
Osseo, MN 55369
Mailing address
220 Central Avenue
Osseo, MN 55369
Phone (763) 425-5525
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 604271 | Other | MN | HEALTH PARTNERS |
| 02D86OS | Other | MN | BCBS |
| 44-40379 | Other | MN | MEDICA |
Other providers in Osseo, MN
- Karl Gustave Johnson
- Marcia L Johnsrud
- Gregory Michael Joiner
- Melissa Marie Kari
- Karis Health, PLLC
- Kristin L Kipka
- Emily Kirkwold
- Karissa Joy Klaers
- Snow Lee
- Hannah D Lewis
All providers in Osseo, MN · Radiology Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.