Delray James Mathiason, D.C.

Individual provider Active NPI Chiropractor · Long Prairie, MN

NPI 1497839187 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1497839187
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
3344 (MN)
Practice address
18 2ND St N
Long Prairie, MN 56347-1118
Phone
(320) 732-3317
Fax
(320) 732-3374
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
604NDMDClinical Psychologist
3344MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Del Carmen Marketing Past
since Jan 1, 2015
Accepting new patients
Vistad Chiropractic Clinic PA Chiropractor Past Accepting new patients
Ruth Wingeier, CNM, LLC Past Accepting new patients
Long Lake Higgins, PC Chiropractor Past
since Jul 1, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3344 MN Yes

Addresses

Primary practice location

18 2ND St N
Long Prairie, MN 56347-1118

Mailing address

18 2ND St N
Long Prairie, MN 56347-1118
Phone (320) 732-3317

Other providers in Long Prairie, MN

All providers in Long Prairie, MN · Chiropractor in Minnesota

Sources for this page

Verify at the official NPI Registry.