Willmar Chiropractic Clinic P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2839 Issued in MN

Legal business name

WILLMAR CHIROPRACTIC CLINIC P.A.

Practice address

1950 19TH Ave SW
Willmar, MN 56201-4925

Phone

(320) 235-7347

Fax

(320) 222-2826

NPI assigned

Jul 15, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Craig Matthew Leis, D.C.NPI 1013903988

Title

President

Phone

(320) 235-7347

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig M. Leis, D.C.

  • Chiropractor
  • Fort Mill, SC
  • NPI 1013903988
  NPD (past) Authorized official
• Patrick Lee Goebel, D.C.

  • Chiropractor
  • Plymouth, MN
  • NPI 1508069766
  NPD (past)

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1417260779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014925",
            "telephone_number": "320-235-7347",
            "fax_number": "320-222-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562014925",
            "telephone_number": "320-235-7347",
            "fax_number": "320-222-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLMAR CHIROPRACTIC CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "LEIS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-235-7347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "725528400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Wilde, MSW, LICSW
• Priscilla K Willander, PA-C
• Kristen Anne Williamson, RD, LDN
• Willmar Autism Services LLC
• Willmar Care Center LLC
• Willmar Commons Nursing & Rehabilitation, Inc.
• Willmar Dental Clinic
• Willmar Family Dentistry, P.a.
• Willmar Family Dentistry, PA
• Willmar Foot & Ankle Clinic

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.