The Walton Clinic, LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1099 Issued in MN

Legal business name

THE WALTON CLINIC, LTD

Practice address

6264 Boone Ave N
Brooklyn Park, MN 55428-2729

Phone

(651) 442-1731

NPI assigned

Oct 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Eric Gordon Koehler, D.C.

Title

President

Phone

(651) 442-1731

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1427334382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6264 BOONE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554282729",
            "telephone_number": "651-442-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6264 BOONE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554282729",
            "telephone_number": "651-442-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WALTON CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "KOEHLER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-442-1731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.