Active Life Chiropractic P.C.

Organization Active NPI Chiropractor · Bismarck, ND

NPI 1609059377 · NPPES record last updated Jan 23, 2008

Key facts

NPI
1609059377
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
ACTIVE LIFE CHIROPRACTIC P.C.
Practice address
535 S 7TH St
Bismarck, ND 58504-5859
Phone
(701) 255-4241
Fax
(701) 255-4299
NPI assigned
Dec 17, 2007
Organization subpart
No

Authorized official

Name
Dr. Sara Jo Weigel, D.C.
Title
President
Phone
(701) 255-4241

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ND

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080117000784 ND Part B Supplier - Clinic/Group Practice 2365523156 Receives reassigned benefits from 3 practitioners
Practice locations: Bismarck, ND

National Provider Directory

Locations

215 W Main Ave
Bismarck, ND 58501
Phone (701) 226-5455

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

535 S 7TH St
Bismarck, ND 58504-5859

Mailing address

535 S 7TH St
Bismarck, ND 58504-5859
Phone (701) 255-4241

Other providers in Bismarck, ND

All providers in Bismarck, ND · Chiropractor in North Dakota

Sources for this page

Verify at the official NPI Registry.