Exponential Chiropractic Healing Center PLLC

Organization Active NPI Chiropractor · Saint Joseph, MN

NPI 1689156358 · NPPES record last updated May 13, 2024

Key facts

NPI
1689156358
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
1386 (MN)
Legal business name
EXPONENTIAL CHIROPRACTIC HEALING CENTER PLLC
Practice address
103 College Ave N
Saint Joseph, MN 56374-9801
Phone
(320) 363-4573
Fax
(320) 363-1314
NPI assigned
Aug 30, 2018
Organization subpart
No

Authorized official

Name
Dr. Brian S Koltes
Title
Owner
Phone
(320) 363-4573

Practitioners 2

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 MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190218002032 MN Part B Supplier - Clinic/Group Practice 3173861176 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Joseph, MN

National Provider Directory

Locations

103 College Ave N
Saint Joseph, MN 56374
Phone (320) 363-4573

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 1386 MN Yes

Addresses

Primary practice location

103 College Ave N
Saint Joseph, MN 56374-9801

Mailing address

103 College Ave N
Saint Joseph, MN 56374-0018
Phone (320) 363-4573

Other identifiers

IdentifierTypeStateIssuer
818825400MedicaidMN

Other providers in Saint Joseph, MN

All providers in Saint Joseph, MN · Chiropractor in Minnesota

Sources for this page

Verify at the official NPI Registry.