Courtney Lynn Pray, D.C.
Individual provider Active NPI Chiropractor · Long Lake, MN
NPI 1386990976 · NPPES record last updated Aug 1, 2012
Key facts
- NPI
- 1386990976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5695 (MN)
- Practice address
- 2073 W Wayzata Blvd
Suite 200
Long Lake, MN 55356-4517 - Phone
- (952) 473-3588
- NPI assigned
- Aug 1, 2012
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5695 | MN | Yes |
Addresses
Primary practice location
2073 W Wayzata Blvd
Suite 200
Long Lake, MN 55356-4517
Mailing address
2073 W Wayzata Blvd
Suite 200
Long Lake, MN 55356-4517
Phone (952) 473-3588
Other providers in Long Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2012. 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.