United Chiropractic Clinic

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

3532 Issued in MN

Legal business name

UNITED CHIROPRACTIC CLINIC

Practice address

995 University Ave W
Suite 101
Saint Paul, MN 55104-4796

Phone

(651) 642-1110

Fax

(651) 642-1113

NPI assigned

Feb 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. Susan H. Pham, DC, DAAPM, DACBN

Title

Director

Phone

(651) 642-1110

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740318146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 UNIVERSITY AVE W",
            "address_2": "SUITE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044796",
            "telephone_number": "651-642-1110",
            "fax_number": "651-642-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 UNIVERSITY AVE W",
            "address_2": "SUITE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044796",
            "telephone_number": "651-642-1110",
            "fax_number": "651-642-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-642-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, DAAPM, DACBN"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "MN",
            "license": "3532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MN",
            "identifier": "5C969PH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "232018",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nutrition Chiropractor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Nutrition Chiropractor 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.