Marty Gullickson Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2596 Issued in MN

Legal business name

MARTY GULLICKSON CHIROPRACTIC

Practice address

17 10TH Ave S
Hopkins, MN 55343

Phone

(952) 927-6639

Fax

(952) 927-0178

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Thomas Gullickson, DC

Title

Owner

Phone

(952) 927-6639

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1306919998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 10TH AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "952-927-6639",
            "fax_number": "952-927-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 10TH AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "952-927-6639",
            "fax_number": "952-927-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTY GULLICKSON CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "GULLICKSON",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-927-6639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2937",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "42G85MA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620071100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcon Hearing Instruments, Inc.
• Rebecca Hea Rin Marks, MA, LMFT
• Scott Andrew Marks
• Stephanie Martin, MA
• Marty Chiropractic Hopkins P.a.
• William Luke Marty, DC
• Colleen Marie Mathisen
• Olivia Ann Matthys, CCC-SLP
• Michael Earl Maus, PH.D.
• Mark D McAlister, A.T.P.

• Chiropractor in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.