Charger Chiropractic & Soft Tissue Center P.C.
Organization Active NPI Chiropractor · Dassel, MN
NPI 1881806552 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1881806552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4884 (MN)
- Legal business name
- CHARGER CHIROPRACTIC & SOFT TISSUE CENTER P.C.
- Practice address
- 450 4TH Street North
Dassel, MN 55321 - Phone
- (320) 275-2000
- Fax
- (320) 275-2800
- NPI assigned
- May 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Shane Mathew Colberg, DC
- Title
- Owner
- Phone
- (320) 275-2000
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070710000471 | MN | Part B Supplier - Clinic/Group Practice | 6709986557 |
Receives reassigned benefits from 1 practitioner Practice locations: Dassel, MN |
National Provider Directory
Locations
450 4th St N
Dassel, MN 55325
Phone (320) 234-4751
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 4884 | MN | Yes |
Addresses
Primary practice location
450 4TH Street North
Dassel, MN 55321
Mailing address
450 4TH Street North
P O Box 2
Dassel, MN 55321
Phone (320) 275-2000
Other providers in Dassel, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.