Waterville Chiropractice Center

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

WATERVILLE CHIROPRACTICE CENTER

Practice address

1400 E Madison Ave
Suite 310
Mankato, MN 56001-5473

Phone

(507) 388-8883

Fax

(507) 388-7620

NPI assigned

Jun 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory J Mongeon, D.C.

Title

Owner

Phone

(507) 388-8883

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Minnesota Institute of Wellness Doing business as

Locations

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508063199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "address_2": "SUITE 310",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "507-388-8883",
            "fax_number": "507-388-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "address_2": "SUITE 310",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "507-388-8883",
            "fax_number": "507-388-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERVILLE CHIROPRACTICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONGEON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-388-8883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "496T8WA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnesota Institute of Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shari Lynn Ward, LPN
• Elizabeth Jean Wargelin, OTR/L
• Mohamed Warsame, M.D
• Cori Lynn Wasz
• Waters Edge at Willow Brook
• Roxanne Ashley Watkins
• Isabella Watts
• We Care Home Care LLC
• Kara Katherine Weber, DDS
• Luke Alan Weber, D.C.

• Occupational Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.