Keith Harlan Novak, D.C.
Individual provider Active NPI Chiropractor · Wabasha, MN
NPI 1487772190 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487772190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1520 (MN)
- Practice address
- 165 Pembroke Ave S
Wabasha, MN 55981-1242 - Phone
- (651) 565-3392
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1520 | MN | Yes |
Addresses
Primary practice location
165 Pembroke Ave S
Wabasha, MN 55981-1242
Mailing address
165 Pembroke Ave S
Wabasha, MN 55981-1242
Phone (651) 565-3392
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 Jul 8, 2007. 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.