# GRAVON'S NATURAL CHIROPRACTIC CENTER P A

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRAVONS NATURAL CHIROPRACTIC CENTER P A
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1205905924
- **Legal business name:** GRAVONS NATURAL CHIROPRACTIC CENTER P A
- **Authorized official:** MS. LORI SCHNIEDER (INSURANCE MGR)
- **Authorized official phone:** (507) 376-9771

## Contact information

- **Practice address:** 1024 OXFORD ST, WORTHINGTON, MN 56187-1681
- **Practice address phone:** (507) 376-9771
- **Practice address fax:** (507) 376-9798
- **Mailing address:** PO BOX 396, WORTHINGTON, MN 56187-0396
- **Mailing address phone:** (507) 376-9771
- **Mailing address fax:** (507) 376-9798

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2237 | MN | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 01/18/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 350048116 | RR MEDICARE PROVIDER NO | MN |
| 05 | — | 548527400 | — | MN |
| 01 | — | 61964GR | BCBS PROVIDER NUMBER | MN |