Ott Family Chiropractic & Wellness Clinic LLC
Organization Active NPI Chiropractor · Wabasha, MN
NPI 1487059291 · NPPES record last updated Oct 14, 2015
Key facts
- NPI
- 1487059291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5950 (MN)
- Legal business name
- OTT FAMILY CHIROPRACTIC & WELLNESS CLINIC LLC
- Practice address
- 165 Pembroke Ave S
Wabasha, MN 55981-1242 - Phone
- (651) 560-4070
- NPI assigned
- Oct 23, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Danielle Ott, D.C.
- Title
- Owner/Chiropractor
- Phone
- (651) 560-4070
Practitioners 1
-
Danielle R. Ott, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151026000323 | MN | Part B Supplier - Clinic/Group Practice | 5698084028 |
Receives reassigned benefits from 1 practitioner Practice locations: Wabasha, MN |
National Provider Directory
Locations
165 Pembroke Ave S
Wabasha, MN 55981
Phone (651) 560-4040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 5950 | MN | Yes |
Addresses
Primary practice location
165 Pembroke Ave S
Wabasha, MN 55981-1242
Mailing address
165 Pembroke Ave S
Wabasha, MN 55981-1242
Other providers in Wabasha, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.